Individual
JAMES L SOUTHWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1004 CARONDELET DR, SUITE 410, KANSAS CITY, MO 64114-4801
(816) 942-4500
(816) 941-4504
Mailing address
1004 CARONDELET DR, SUITE 410, KANSAS CITY, MO 64114-4801
(816) 942-4500
(816) 941-4504
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
04-06053
KS
2084N0400X
Neurology Physician
Primary
2010034070
MO
2084N0400X
Neurology Physician
O-0465
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740306273
—
MO
05
—
200681570A
—
KS
01
—
44833018
BLUE CROSS BLUE SHIELD OF KC
—
Enumeration date
03/22/2007
Last updated
01/20/2012
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