Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 04-43912 | KS |
N | 207W00000X | Ophthalmologist | 2019017101 | MO |
NPI | 1033435318 |
---|---|
Provider Name | Daniel Bettis |
First Address | Kansas City, MO 64154-2700 |
Second Address | Kansas City, MO 64154-2700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2010 |
Last Update Date | 08/11/2021 |