Basic Information
| Provider Information | |||||||||
| NPI: | 1740306851 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAGAN | ||||||||
| FirstName: | STUART | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12005 OVERBROOK RD | ||||||||
| Address2: | |||||||||
| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662091149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9134911464 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14809 W. 95TH ST. | ||||||||
| Address2: | |||||||||
| City: | LENEXA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662151282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9138946664 | ||||||||
| FaxNumber: | 9139049147 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083X0100X | 14573 | KS | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.