Provider Demographics
NPI:1144340233
Name:BANISTER, JAY FRANK III (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:FRANK
Last Name:BANISTER
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:4801 E LINWOOD BLVD
Mailing Address - Street 2:VA MED CENTER/MENTAL HYGIENE CLINIC
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64128-2226
Mailing Address - Country:US
Mailing Address - Phone:816-922-2641
Mailing Address - Fax:816-922-4652
Practice Address - Street 1:4801 E LINWOOD BLVD
Practice Address - Street 2:VA MED CENTER/MENTAL HYGIENE CLINIC
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64128-2226
Practice Address - Country:US
Practice Address - Phone:816-922-2641
Practice Address - Fax:816-922-4652
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2013-04-09
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Provider Licenses
StateLicense IDTaxonomies
MO2008015998207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine