Healthcare Provider Details

I. General information

NPI: 1801920780
Provider Name (Legal Business Name): VALERIE ANNE DEARDORFF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 09/30/2022
Certification Date: 09/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10777 NALL AVE STE 300
OVERLAND PARK KS
66211-1330
US

IV. Provider business mailing address

10777 NALL AVE STE 300
OVERLAND PARK KS
66211-1330
US

V. Phone/Fax

Practice location:
  • Phone: 913-642-0200
  • Fax: 913-563-6699
Mailing address:
  • Phone: 913-642-0200
  • Fax: 913-563-6699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number04-31019
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number2007023615
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: