MEDICARE: DR. ROBERT A MOULTON D.O.

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	174400000X	Specialist	530033	KS
2	207V00000X	Obstetrics & Gynecology Physician	530033	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821072216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT A MOULTON D.O.

Provider Business Mailing Address
First Line	:	10550 QUIVIRA RD
Second Line	:	SUITE 410
City	:	OVERLAND PARK
State	:	KS
Zip	:	66215-2306
Country	:	US
Telephone Number	:	913-541-0990
Fax Number	:	913-541-1452

Provider Business Practice Location Address
First Line	:	10550 QUIVIRA RD
Second Line	:	SUITE 410
City	:	OVERLAND PARK
State	:	KS
Zip	:	66215-2306
Country	:	US
Telephone Number	:	913-541-0990
Fax Number	:	913-541-1452

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	06/10/2026

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Directions to “ DR. ROBERT A MOULTON D.O.” Practice Location

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