Individual
BRUCE E FEARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3521 NE RALPH POWELL RD, SUITE C, LEES SUMMIT, MO 64064-2360
(816) 554-7546
(816) 554-9470
Mailing address
3521 NE RALPH POWELL RD, SUITE C, LEES SUMMIT, MO 64064-2360
(816) 554-7546
(816) 554-9470
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
102868
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207707209
—
MO
Enumeration date
08/22/2005
Last updated
08/30/2022
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