Healthcare Provider Details

I. General information

NPI: 1194718288
Provider Name (Legal Business Name): ANTHONY J. GUNN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4811 S ARROWHEAD DR
INDEPENDENCE MO
64055-6981
US

IV. Provider business mailing address

8550 MARSHALL DR STE 220
LENEXA KS
66214-1505
US

V. Phone/Fax

Practice location:
  • Phone: 816-356-5000
  • Fax: 913-495-3742
Mailing address:
  • Phone: 816-356-5000
  • Fax: 913-495-3742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD110468
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number110468
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: