Provider Demographics
NPI:1730152679
Name:COSTER, JAMES R (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:COSTER
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 1:10701 NALL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1244
Mailing Address - Country:US
Mailing Address - Phone:913-338-5585
Mailing Address - Fax:913-338-3228
Practice Address - Street 1:5300 INDIAN CREEK PKWY
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66207-3850
Practice Address - Country:US
Practice Address - Phone:913-456-5274
Practice Address - Fax:913-954-4769
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO1046842085R0001X
KS04-246662085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100147260CMedicaid
KS100147260FMedicaid
MO1730152679Medicaid
MO1730152679Medicaid
KS100147260FMedicaid
KSE26987Medicare UPIN
MOMA3347022Medicare PIN