Provider Demographics
NPI:1467492314
Name:HERNANDEZ-RIOS, PABLO J (MD)
Entity Type:Individual
Prefix:
First Name:PABLO
Middle Name:J
Last Name:HERNANDEZ-RIOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2750 CLAY EDWARDS DR
Mailing Address - Street 2:SUITE 420
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3237
Mailing Address - Country:US
Mailing Address - Phone:816-241-0928
Mailing Address - Fax:816-936-8118
Practice Address - Street 1:2750 CLAY EDWARDS DR
Practice Address - Street 2:SUITE 420
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3237
Practice Address - Country:US
Practice Address - Phone:816-241-0928
Practice Address - Fax:816-936-8118
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2006008749207ZP0102X, 207ZC0500X
GA054512207ZC0500X, 207ZP0102X
KS04-31892207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS04-31892OtherSTATE MEDICAL LICENSE
MO2006008749OtherSTATE MEDICAL LICENSE
GA054512OtherSTATE MEDICAL LICENSE