Healthcare Provider Details

I. General information

NPI: 1225973191
Provider Name (Legal Business Name): THOMAS K BRISTOW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OLATHE
KANSAS CITY KS
66160-8505
US

IV. Provider business mailing address

2000 OLATHE
KANSAS CITY KS
66160-8505
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1908
  • Fax:
Mailing address:
  • Phone: 913-588-1908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number94-12799
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: