MEDICARE: DR. SANDRA M ARCHER M.D.

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
1	207Q00000X	Family Medicine Physician	2004019667	MO
2	207Q00000X	Family Medicine Physician	0432534	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00410909	OTHER		MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	38584011	OTHER		BCBSKC
2	463377	OTHER		CMFHP

General Provider Information

NPI Number	:	1255325973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA M ARCHER M.D.

Provider Business Mailing Address
First Line	:	9800 TROUP AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66111-1870
Country	:	US
Telephone Number	:	913-297-7472
Fax Number	:	913-788-5878

Provider Business Practice Location Address
First Line	:	9800 TROUP AVENUE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66111-1870
Country	:	US
Telephone Number	:	913-297-7472
Fax Number	:	913-788-5878

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	11/18/2025

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Directions to “ DR. SANDRA M ARCHER M.D.” Practice Location

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