Healthcare Provider Details

I. General information

NPI: 1477087765
Provider Name (Legal Business Name): EILEEN CASEY DONOVAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 SHAWNEE MISSION PKWY
WESTWOOD KS
66205-2003
US

IV. Provider business mailing address

4000 CAMBRIDGE ST # MS 2005
KANSAS CITY KS
66160-8501
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-7750
  • Fax:
Mailing address:
  • Phone: 913-588-7750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number04-54081
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: