Provider Demographics
NPI:1114193570
Name:DANA R TOWLE MD PC
Entity type:Organization
Organization Name:DANA R TOWLE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:TOWLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-452-8080
Mailing Address - Street 1:4444 N BELLEVIEW AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-1507
Mailing Address - Country:US
Mailing Address - Phone:816-452-8080
Mailing Address - Fax:816-454-9346
Practice Address - Street 1:4444 N BELLEVIEW AVE STE 204
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-1507
Practice Address - Country:US
Practice Address - Phone:816-452-8080
Practice Address - Fax:816-454-9346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7J002082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E60374Medicare UPIN
MOMA1064001Medicare PIN