NPI 1053307702 · live from the CMS NPI Registry
Mark G. Coble, OD
Optometrist in Kansas City, KS. National Provider Identifier 1053307702, active.
NPI record
| NPI | 1053307702 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 9501 State Ave, Suite 2, Kansas City, KS 66111 |
| Practice phone | 913-299-7200 |
| Mailing address | 9501 State Ave, Ste 2, Kansas City, KS 66111 |
| Enumerated | September 27, 2005 |
| Last updated | August 17, 2016 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 1098-3 (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.