Healthcare Provider Details

I. General information

NPI: 1699469767
Provider Name (Legal Business Name): ANDREW JAMES FANCHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CAMBRIDGE ST
KANSAS CITY KS
66160-8505
US

IV. Provider business mailing address

4000 CAMBRIDGE ST
KANSAS CITY KS
66160-8505
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-9600
  • Fax: 913-274-3512
Mailing address:
  • Phone: 913-588-9600
  • Fax: 913-274-3512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number94-11505
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: