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Organization

COLORECTAL SURGERY ASSOCIATES PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KERI POLTON (OFFICE MANAGER)
(816) 285-8479
Entity
Organization

Contact information

Practice address
4370 W 109TH ST, SUITE 350, OVERLAND PARK, KS 66211-1361
(816) 941-0800
(816) 941-0080
Mailing address
6060 N OAK TRFY, SUITE 101, GLADSTONE, MO 64118-5130
(816) 941-0800
(816) 941-0080

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200298620A
KS
05
502936800
MO
Enumeration date
06/13/2005
Last updated
07/21/2022
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