Provider Demographics
NPI:1316927544
Name:MAGERA, JAMES S JR (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:MAGERA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2529 GLENN HENDREN DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-9607
Mailing Address - Country:US
Mailing Address - Phone:816-781-8400
Mailing Address - Fax:816-781-8263
Practice Address - Street 1:2529 GLENN HENDREN DR STE 202
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-9602
Practice Address - Country:US
Practice Address - Phone:816-781-8400
Practice Address - Fax:816-781-8263
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010006699208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN327108100Medicaid
43625029OtherBCBS KC
H88913Medicare UPIN
MN327108100Medicaid
MNP00030707Medicare ID - Type UnspecifiedRAILROAD
43625029OtherBCBS KC