Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2013044595 | MO |
Y | 208600000X | Surgeon | 2013044595 | MO |
NPI | 1003237496 |
---|---|
Provider Name | Dr. Kyle Harken |
First Address | Blue Springs, MO 64014-2513 |
Second Address | Blue Springs, MO 64014-2513 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2014 |
Last Update Date | 02/01/2014 |