Healthcare Provider Details

I. General information

NPI: 1508970948
Provider Name (Legal Business Name): CONSTANTINE FARMAKIDIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3599 RAINBOW BLVD
KANSAS CITY KS
66103-2078
US

IV. Provider business mailing address

4000 CAMBRIDGE ST
KANSAS CITY KS
66160-8501
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6903
  • Fax:
Mailing address:
  • Phone: 913-588-6903
  • Fax: 913-588-7177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number04-40317
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number04-40317
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: