MEDICARE: DR. KELSEY LAINE ABLE DO

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	207RG0100X	Gastroenterology Physician	FA5212911	KS
2	207R00000X	Internal Medicine Physician	9407993	KS

General Provider Information

NPI Number	:	1376806588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELSEY LAINE ABLE DO

Provider Business Mailing Address
First Line	:	17501 E 40 HWY STE 213A
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64055-6445
Country	:	US
Telephone Number	:	816-478-4887
Fax Number	:	816-478-7140

Provider Business Practice Location Address
First Line	:	5330 N OAK TRFY STE 102
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-4600
Country	:	US
Telephone Number	:	816-478-4887
Fax Number	:	816-478-7140

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

Provider Enumeration Date	:	06/21/2012
Last Update Date	:	08/03/2022

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