Basic Information
Provider Information
NPI: 1487793493
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRIGG
FirstName: MICHAEL
MiddleName: JOSEPH
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5800 FOXRIDGE DR
Address2: SUITE 240
City: MISSION
State: KS
PostalCode: 662022347
CountryCode: US
TelephoneNumber: 9132613153
FaxNumber: 9132623295
Practice Location
Address1: 8929 PARALLEL PKWY
Address2:  
City: KANSAS CITY
State: KS
PostalCode: 661121689
CountryCode: US
TelephoneNumber: 9135964118
FaxNumber: 9135964119
Other Information
ProviderEnumerationDate: 02/06/2007
LastUpdateDate: 05/25/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X2004-0256NMN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X04-33474KSY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X2008032496MON Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
200611460B05KS MEDICAID


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