Provider Demographics
NPI:1538146063
Name:KALBAC, RICHARD WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:WILLIAM
Last Name:KALBAC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6400 PROSPECT
Mailing Address - Street 2:# 598
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-4128
Mailing Address - Country:US
Mailing Address - Phone:816-444-6888
Mailing Address - Fax:816-444-1375
Practice Address - Street 1:2790 CLAY EDWARDS DR
Practice Address - Street 2:# 625
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3278
Practice Address - Country:US
Practice Address - Phone:816-421-3115
Practice Address - Fax:816-444-1375
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2012-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO32830207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200836534Medicaid
D72759Medicare UPIN
MO200836534Medicaid