Provider Demographics
NPI:1194824482
Name:THRASHER, J. BRANTLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:J.
Middle Name:BRANTLEY
Last Name:THRASHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3901 RAINBOW BLVD.
Mailing Address - Street 2:4070 DELP MAIL STOP 4017
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-6152
Mailing Address - Fax:913-588-7625
Practice Address - Street 1:3901 RAINBOW BLVD.
Practice Address - Street 2:DEPT. OF UROLOGY, MAIL STOP 3016
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-6152
Practice Address - Fax:913-588-7625
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-27596208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS668750OtherFIRSTGUARD
MO25160037OtherBCBS KANSAS CITY
0098497AMedicare ID - Type Unspecified
G75397Medicare UPIN