Provider Demographics
NPI:1871564286
Name:OSGOOD, BRIAN M (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:M
Last Name:OSGOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9200 INDIAN CREEK PKWY
Mailing Address - Street 2:BUILDING 9, SUITE 300
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2002
Mailing Address - Country:US
Mailing Address - Phone:913-574-2800
Mailing Address - Fax:913-574-2336
Practice Address - Street 1:4881 NE GOODVIEW CIR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-1996
Practice Address - Country:US
Practice Address - Phone:913-574-2350
Practice Address - Fax:913-574-2413
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2016-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR7F00207RH0003X
KS04-29659207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100387520CMedicaid
MO1871564286Medicaid
MOC51046Medicare UPIN
MO1871564286Medicaid
KS100387520CMedicaid