Basic Information
| Provider Information | |||||||||
| NPI: | 1831291137 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AL-KASSPOOLES | ||||||||
| FirstName: | MAZIN | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4000 CAMBRIDGE ST # MS 2005 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661608501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135887750 | ||||||||
| FaxNumber: | 9139459300 | ||||||||
| Practice Location | |||||||||
| Address1: | 2650 SHAWNEE MISSION PKWY | ||||||||
| Address2: | |||||||||
| City: | WESTWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662052003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135887750 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2006 | ||||||||
| LastUpdateDate: | 01/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 04-31498 | KS | N | Allopathic & Osteopathic Physicians | Surgery | 2086X0206X | 04-31498 | KS | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 207576802 | 05 | MO | MEDICAID | 927869 | 01 | KS | FIRSTGUARD | OTHER | 35920013 | 01 | MO | BCBS KANSAS CITY | OTHER | 200348460A | 05 | KS | MEDICAID |