Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 04-39187 | KS |
N | 111NI0900X | Internist | 04-39187 | KS |
Y | 207R00000X | Internist | 2017039278 | MO |
Y | 111NI0900X | Internist | 2017039278 | MO |
NPI | 1003195215 |
---|---|
Provider Name | Dr. Philip Barigbi Augustine |
First Address | Kansas City, MO 64116-1779 |
Second Address | Kansas City, MO 64116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2011 |
Last Update Date | 13/05/2021 |