Provider Demographics
NPI:1740306851
Name:KAGAN, STUART M (MD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:M
Last Name:KAGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:12005 OVERBROOK RD
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-1149
Mailing Address - Country:US
Mailing Address - Phone:913-491-1464
Mailing Address - Fax:
Practice Address - Street 1:14809 W. 95TH ST.
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-1282
Practice Address - Country:US
Practice Address - Phone:913-894-6664
Practice Address - Fax:913-904-9147
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS145732083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine