Basic Information
| Provider Information | |||||||||
| NPI: | 1538216353 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAUGHRON | ||||||||
| FirstName: | SAMUEL | ||||||||
| MiddleName: | K. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9705 LENEXA DR | ||||||||
| Address2: | |||||||||
| City: | LENEXA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662151345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162413338 | ||||||||
| FaxNumber: | 8169368118 | ||||||||
| Practice Location | |||||||||
| Address1: | 2750 CLAY EDWARDS DR | ||||||||
| Address2: | SUITE 420 | ||||||||
| City: | N KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641163237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162413338 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 08/25/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0007X | 11434 | MT | N | Allopathic & Osteopathic Physicians | Pathology | Molecular Genetic Pathology | 207ZP0102X | 2009024405 | MO | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207ZP0102X | 11434 | MT | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207ZP0102X | 04-33937 | KS | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207ZP0007X | 04-33937 | KS | N | Allopathic & Osteopathic Physicians | Pathology | Molecular Genetic Pathology | 207ZP0007X | 2009024405 | MO | N | Allopathic & Osteopathic Physicians | Pathology | Molecular Genetic Pathology |
No ID Information.