Healthcare Provider Details

I. General information

NPI: 1619965142
Provider Name (Legal Business Name): FOXHALL PARKER THORNTON III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 10/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 W 74TH ST SUITE 121
SHAWNEE MISSION KS
66204-2204
US

IV. Provider business mailing address

11755 W 112TH ST SUITE 203
OVERLAND PARK KS
66210-2761
US

V. Phone/Fax

Practice location:
  • Phone: 913-261-2223
  • Fax: 913-261-2224
Mailing address:
  • Phone: 913-469-0503
  • Fax: 913-338-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number0422846
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: