Provider Demographics
NPI:1538216353
Name:CAUGHRON, SAMUEL K (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:K
Last Name:CAUGHRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9705 LENEXA DR
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-1345
Mailing Address - Country:US
Mailing Address - Phone:816-241-3338
Mailing Address - Fax:816-936-8118
Practice Address - Street 1:2750 CLAY EDWARDS DR
Practice Address - Street 2:SUITE 420
Practice Address - City:N KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3237
Practice Address - Country:US
Practice Address - Phone:816-241-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11434207ZP0007X, 207ZP0102X
MO2009024405207ZP0102X, 207ZP0007X
KS04-33937207ZP0102X, 207ZP0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology