Provider Demographics
NPI:1295768190
Name:MONACO, JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:MONACO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1209 NW NORTH RIDGE DR STE B
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-6320
Mailing Address - Country:US
Mailing Address - Phone:816-988-8415
Mailing Address - Fax:816-988-8395
Practice Address - Street 1:2301 HOLMES ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2677
Practice Address - Country:US
Practice Address - Phone:816-404-1127
Practice Address - Fax:816-404-1103
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010008622207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204210900Medicaid