Provider Demographics
NPI:1063674596
Name:ALSOP, BENJAMIN RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:RICHARD
Last Name:ALSOP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 NE SAINT LUKES BLVD STE 530
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-6075
Mailing Address - Country:US
Mailing Address - Phone:816-554-3838
Mailing Address - Fax:816-554-1634
Practice Address - Street 1:110 NE SAINT LUKES BLVD STE 530
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086
Practice Address - Country:US
Practice Address - Phone:816-554-3838
Practice Address - Fax:816-554-1634
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-35016207RG0100X
MO2018011080207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology