Provider Demographics
NPI:1336450428
Name:COWAN, PAUL CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:CHRISTOPHER
Last Name:COWAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19550 E 39TH ST S
Mailing Address - Street 2:STE 410
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2358
Mailing Address - Country:US
Mailing Address - Phone:816-303-2400
Mailing Address - Fax:816-889-1584
Practice Address - Street 1:19550 E 39TH ST S STE 410
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2307
Practice Address - Country:US
Practice Address - Phone:816-303-2400
Practice Address - Fax:816-303-2484
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016008223207X00000X, 207XX0005X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery