Healthcare Provider Details

I. General information

NPI: 1912298001
Provider Name (Legal Business Name): STEPHEN VINCENT HIATT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2011
Last Update Date: 07/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 NALL AVENUE, SUITE 200
OVERLAND PARK KS
66211
US

IV. Provider business mailing address

10701 NALL AVENUE, SUITE 200
OVERLAND PARK KS
66211
US

V. Phone/Fax

Practice location:
  • Phone: 913-381-5225
  • Fax: 913-901-0186
Mailing address:
  • Phone: 913-381-5225
  • Fax: 913-901-0186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number04-37415
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number2014008806
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: