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NPI Code Detail

MEDICARE: DR. FARRELL S. WEIERS PHD

MEDICARE:  DR. FARRELL S. WEIERS  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC2200XClinical Child & Adolescent Psychologist2009030746MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
143714011OTHERBLUE CROSS BLUE SHIELD KANSAS CITY

General Provider Information

NPI Number : 1023336765
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FARRELL S. WEIERS PHD
Provider Business Mailing Address
First Line : 7280 NW 87TH TER
Second Line : SUITE 210
City : KANSAS CITY
State : MO
Zip : 64153-3720
Country : US
Telephone Number : 816-841-7929
Fax Number : 816-841-7701
Provider Business Practice Location Address
First Line : 7280 NW 87TH TER
Second Line : SUITE 210
City : KANSAS CITY
State : MO
Zip : 64153-3720
Country : US
Telephone Number : 816-841-7929
Fax Number : 816-841-7701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2010
Last Update Date : 05/05/2010

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