Healthcare Provider Details

I. General information

NPI: 1124091384
Provider Name (Legal Business Name): ROBERT L TALLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12330 METCALF AVE STE 580
OVERLAND PARK KS
66213-1308
US

IV. Provider business mailing address

901 E 104TH ST # MS 400S
KANSAS CITY MO
64131-4517
US

V. Phone/Fax

Practice location:
  • Phone: 913-317-3230
  • Fax:
Mailing address:
  • Phone: 913-317-3230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number04-18959
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number2003003699
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: