Provider Demographics
NPI:1245679760
Name:ARGUBRIGHT, MARISA (DO)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:ARGUBRIGHT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11725 W 112TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2761
Mailing Address - Country:US
Mailing Address - Phone:913-469-5579
Mailing Address - Fax:913-469-0824
Practice Address - Street 1:11725 W 112TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2761
Practice Address - Country:US
Practice Address - Phone:913-469-5579
Practice Address - Fax:913-469-0824
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-39367207Q00000X
MO2013019109207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine