Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 2020020740 | MO |
NPI | 1003349994 |
---|---|
Provider Name | Mr. Colton Michael Bitely |
First Address | Leawood, KS 66209-2238 |
Second Address | Lees Summit, MO 64063-1007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2017 |
Last Update Date | 23/07/2020 |