Basic Information
| Provider Information | |||||||||
| NPI: | 1801528351 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAPITOL PATHOLOGY SPECIALISTS GROUP | ||||||||
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| Address1: | 2203 TWIN OAKS DR APT 67 | ||||||||
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| City: | HARRISONVILLE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 647012972 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027445124 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4801 LINWOOD BLVD | ||||||||
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| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641284411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8168614700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2022 | ||||||||
| LastUpdateDate: | 10/03/2022 | ||||||||
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| AuthorizedOfficialLastName: | CAGLE | ||||||||
| AuthorizedOfficialFirstName: | BETTY SUE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2027445124 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PHD, MD | ||||||||
| NPICertificationDate: | 10/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 208M00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.