Healthcare Provider Details

I. General information

NPI: 1487620191
Provider Name (Legal Business Name): DEBORAH B OHLHAUSEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 04/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 N OAK TRFY STE 201
KANSAS CITY MO
64118-4699
US

IV. Provider business mailing address

5310 HARVEST HILL RD STE 290
DALLAS TX
75230-5826
US

V. Phone/Fax

Practice location:
  • Phone: 816-454-0666
  • Fax: 816-454-1694
Mailing address:
  • Phone: 214-420-0650
  • Fax: 214-736-0512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number109156
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: