Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 23413 | KS |
NPI | 1003810896 |
---|---|
Provider Name | Richard Brooke Price |
First Address | Overland Park, KS 66213-1305 |
Second Address | Overland Park, KS 66211-1891 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 31/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13787011 | BCBS PROVIDER # (01) | SC |