Healthcare Provider Details

I. General information

NPI: 1043439102
Provider Name (Legal Business Name): ANNE P. O'DEA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 SHAWNEE MISSION PARKWAY SUITE 1102
WESTWOOD KS
66205
US

IV. Provider business mailing address

2650 SHAWNEE MISSION PARKWAY SUITE 1102
WESTWOOD KS
66205
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-7791
  • Fax: 913-588-3648
Mailing address:
  • Phone: 913-588-7791
  • Fax: 913-588-3648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number0432484
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: