Doctor Name: | DR. MARK REDICK |
NPI Number: | 1063489631 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 111830 |
Business Practice Address: | 2330 Shawnee Mission Pkwy Westwood, KS - 662052005 |
Business Phone Number: | 9135886805 |
Business Fax Number: | 9135887899 |
Mailing Address: | Po Box 411851, KANSAS CITY |
State: | MO |
Postal Code: | 641411851 |
Phone Number: | 9135886805 |
Fax Number: | 9135887899 |
NPI Enumeration Date: | 03/02/2006 |
NPI Last Update Date: | 08/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 111830 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |