Individual
LANCE WALDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401 WORNALL RD, KANSAS CITY, MO 64111-3220
(816) 932-2047
Mailing address
PO BOX 78009, SAINT LOUIS, MO 63178-8009
(866) 898-7142
(616) 975-9824
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
119206
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26012016
BCBS
—
Enumeration date
08/16/2006
Last updated
12/17/2007
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