Healthcare Provider Details

I. General information

NPI: 1154417863
Provider Name (Legal Business Name): HEIDI S CHUMLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI S JONES

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 01/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1059B DELP PAVILION MAIL STOP 4010
KANSAS CITY KS
66160
US

IV. Provider business mailing address

3901 RAINBOW BLVD 4070 DELP MAIL STOP 4010
KANSAS CITY KS
66160
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 Number04-30811
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: