Provider Demographics
NPI:1255433561
Name:FORSTER, JAMESON (MD)
Entity type:Individual
Prefix:DR
First Name:JAMESON
Middle Name:
Last Name:FORSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:816-599-9499
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:4320 WORNALL RD
Practice Address - Street 2:SUITE 240
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5941
Practice Address - Country:US
Practice Address - Phone:816-932-4655
Practice Address - Fax:816-932-7920
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-22921208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100115990AMedicaid
MO15364018OtherBCBS KANSAS CITY
MO202706107Medicaid
KS625770OtherFIRSTGUARD
KS100115990AMedicaid
0091132AMedicare ID - Type Unspecified
MO15364018OtherBCBS KANSAS CITY