Provider Demographics
NPI:1740416023
Name:RARICK, JASON MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:MICHAEL
Last Name:RARICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7301 COLLEGE BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1937
Mailing Address - Country:US
Mailing Address - Phone:913-341-6297
Mailing Address - Fax:913-341-6299
Practice Address - Street 1:7301 COLLEGE BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1937
Practice Address - Country:US
Practice Address - Phone:913-341-6297
Practice Address - Fax:913-341-6299
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2016-03-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-37149207ZP0102X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology