Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2018011482 | MO |
Y | 208600000X | Surgeon | 2018011482 | MO |
N | 208200000X | Surgeon | 94-07623 | KS |
N | 208600000X | Surgeon | 94-07623 | KS |
N | 2086S0129X | Vascular Surgeon | 2018011482 | MO |
NPI | 1023301413 |
---|---|
Provider Name | Mrs. Samantha Machen Alsop |
First Address | Kansas City, KS 64111 |
Second Address | Kansas City, MO 64111-5943 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2011 |
Last Update Date | 09/12/2020 |