Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 2008019023 | MO |
N | 208000000X | Pediatrician | 2008019023 | MO |
Y | 2080P0204X | Pediatric Emergency Doctor | 2008019023 | MO |
NPI | 1487703534 |
---|---|
Provider Name | John D Lantos |
First Address | Kansas City, MO 64108 |
Second Address | Kansas City, MO 64108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 10/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1487703534 | (05) | MO |
C39164 | (02) | IL |