Healthcare Provider Details

I. General information

NPI: 1174580088
Provider Name (Legal Business Name): GREGORY ALAN ATOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RAINBOW BLVD MS 3010
KANSAS CITY KS
66160-8500
US

IV. Provider business mailing address

PO BOX 411851 UNIVERSITY OF PHYSICIANS INC
KANSAS CITY MO
64141-1851
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6701
  • Fax: 913-588-6708
Mailing address:
  • Phone: 913-588-6701
  • Fax: 913-588-6708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number110277
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: