Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 5101017678 | MI |
N | 207V00000X | Obstetrician & Gynecologist | OS015980 | PA |
N | 207VX0201X | Gynecologic Oncologist | 0538312 | KS |
Y | 207VX0201X | Gynecologic Oncologist | 2015025644 | MO |
NPI | 1013172022 |
---|---|
Provider Name | Dr. Kristopher Shawn Lybarger |
First Address | Kansas City, MO 64132-1105 |
Second Address | Kansas City, MO 64132-1105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2008 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102699106 | (05) | PA |
1609940 | GATEWAY (01) | PA |
2697299 | HIGHMARK BLUE SHIELD (01) | PA |
30120311 | AMERIHEALTH MERCY - WMG (01) | PA |
418499 | UPMC (01) | PA |