Basic Information
Provider Information
NPI: 1659647493
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOZARTH
FirstName: MARGARET
MiddleName: ROSE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WESSLING
OtherFirstName: MARGARET
OtherMiddleName: ROSE
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 901 E. 104TH ST
Address2: MAILSTOP 400N
City: KANSAS CITY
State: MO
PostalCode: 64131
CountryCode: US
TelephoneNumber: 8165027104
FaxNumber: 8169329670
Practice Location
Address1: 4061 INDIAN CREEK PKWY STE 200
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662074030
CountryCode: US
TelephoneNumber: 9133177990
FaxNumber: 9133234716
Other Information
ProviderEnumerationDate: 03/27/2012
LastUpdateDate: 02/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X2012020337MON Allopathic & Osteopathic PhysiciansPediatrics 
207R00000X2012020337MOY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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