Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | R8942 | MO |
NPI | 1457351033 |
---|---|
Provider Name | Dr. Frank W Shagets |
First Address | Joplin, MO 64801-1040 |
Second Address | Pittsburg, KS 66762-2546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 29/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040017042 | RAILROAD MEDICARE PART B (01) | MO |
202543005 | (05) | MO |
A11691 | (02) | MO |