Healthcare Provider Details

I. General information

NPI: 1033224779
Provider Name (Legal Business Name): DORIS H ZHONG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13830 S US HIGHWAY 71
GRANDVIEW MO
64030
US

IV. Provider business mailing address

2400 SW GOLDEN EAGLE RD
LEES SUMMIT MO
64082-4097
US

V. Phone/Fax

Practice location:
  • Phone: 816-761-4664
  • Fax:
Mailing address:
  • Phone: 816-524-7808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number2005024070
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: