Healthcare Provider Details

I. General information

NPI: 1487657409
Provider Name (Legal Business Name): ROBERT L PIERRON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10600 MASTIN ST
OVERLAND PARK KS
66212-5723
US

IV. Provider business mailing address

PO BOX 741331
ATLANTA GA
30374-1331
US

V. Phone/Fax

Practice location:
  • Phone: 913-469-6447
  • Fax: 913-825-3716
Mailing address:
  • Phone: 913-469-6447
  • Fax: 913-338-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberR2A47
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number04-16839
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: