Provider Demographics
NPI:1225265770
Name:D'ANGELO, JONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:D'ANGELO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:KANSAS UNIVERSITY MEDICAL CTR
Mailing Address - Street 2:3901 RAINBOW BLVD MAILSTOP 1034
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-3304
Mailing Address - Fax:913-588-3365
Practice Address - Street 1:KANSAS UNIVERSITY MEDICAL CTR
Practice Address - Street 2:3901 RAINBOW BLVD MAILSTOP 1034
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-3304
Practice Address - Fax:913-588-3365
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2010-08-10
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Provider Licenses
StateLicense IDTaxonomies
OK27249207R00000X
KS9407566207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine