Provider Demographics
NPI:1871672287
Name:BLOCK, MARGO LYNN (DO)
Entity type:Individual
Prefix:DR
First Name:MARGO
Middle Name:LYNN
Last Name:BLOCK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:19550 E 39TH ST S
Mailing Address - Street 2:SUITE 105A
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2358
Mailing Address - Country:US
Mailing Address - Phone:816-833-0466
Mailing Address - Fax:816-833-4155
Practice Address - Street 1:19550 E 39TH ST S
Practice Address - Street 2:SUITE 105A
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2358
Practice Address - Country:US
Practice Address - Phone:816-833-0466
Practice Address - Fax:816-833-4155
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL38682084N0400X
WI48071-0212084N0400X
MO2008143882084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200584880 AMedicaid
MO1871672287Medicaid
MOP00654737Medicare PIN
MOS36000003Medicare PIN