Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | MDR5H70 | MO |
NPI | 1043299266 |
---|---|
Provider Name | Scott S Talpers |
First Address | Liberty, MO 64068-3388 |
Second Address | Liberty, MO 64068-3388 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2006 |
Last Update Date | 18/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16360011 | BCBS (01) | MO |
A12901 | (02) | MO |