Individual
MR. RANDY J TARVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1741 NE DOUGLAS ST, SUITE 200, LEES SUMMIT, MO 64086-4703
(816) 246-0200
(816) 246-0220
Mailing address
8550 MARSHALL DR, SUITE 220, LENEXA, KS 66214-1505
(816) 246-0200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0422753
KS
207Q00000X
Family Medicine Physician
Primary
MD 111602
MO
Other
Enumeration date
09/15/2005
Last updated
08/18/2009
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