Provider Demographics
NPI:1831291137
Name:AL-KASSPOOLES, MAZIN F (MD)
Entity type:Individual
Prefix:DR
First Name:MAZIN
Middle Name:F
Last Name:AL-KASSPOOLES
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 1:4000 CAMBRIDGE ST # MS 2005
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8501
Mailing Address - Country:US
Mailing Address - Phone:913-588-7750
Mailing Address - Fax:913-945-9300
Practice Address - Street 1:2650 SHAWNEE MISSION PKWY
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-2003
Practice Address - Country:US
Practice Address - Phone:913-588-7750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-31498208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207576802Medicaid
KS927869OtherFIRSTGUARD
MO35920013OtherBCBS KANSAS CITY
KS200348460AMedicaid
H67763Medicare UPIN