Provider Demographics
NPI:1942391248
Name:CHRISTIFANO, LOUIS D (DO)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:D
Last Name:CHRISTIFANO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 412554
Mailing Address - Street 2:LEAWOOD FAMILY CARE P.A.
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141
Mailing Address - Country:US
Mailing Address - Phone:913-338-4515
Mailing Address - Fax:913-338-4606
Practice Address - Street 1:11301 ASH STREET
Practice Address - Street 2:LEAWOOD FAMILY CARE, P.A.
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211
Practice Address - Country:US
Practice Address - Phone:913-338-4515
Practice Address - Fax:913-338-4606
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO102060207Q00000X
KS05-25297207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSM116343Medicare PIN
F86886Medicare UPIN