Provider Demographics
NPI:1801193644
Name:SERAFINI, GHAISON FRANK (DO)
Entity Type:Individual
Prefix:DR
First Name:GHAISON
Middle Name:FRANK
Last Name:SERAFINI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1501 NW MOCK AVE
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-3096
Mailing Address - Country:US
Mailing Address - Phone:816-224-3155
Mailing Address - Fax:816-224-3185
Practice Address - Street 1:1501 NW MOCK AVE
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-3096
Practice Address - Country:US
Practice Address - Phone:816-224-3155
Practice Address - Fax:816-224-3185
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2013035498208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice