Provider Demographics
NPI:1225149537
Name:RODGERS STANLEY, RITA C (MD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:C
Last Name:RODGERS STANLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 480
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64089-0480
Mailing Address - Country:US
Mailing Address - Phone:816-444-6055
Mailing Address - Fax:816-444-6033
Practice Address - Street 1:6650 TROOST AVE
Practice Address - Street 2:STE 205
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1215
Practice Address - Country:US
Practice Address - Phone:816-444-6055
Practice Address - Fax:816-444-6033
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9J37207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP291524Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
MOC21805Medicare UPIN