Healthcare Provider Details

I. General information

NPI: 1477507002
Provider Name (Legal Business Name): JAMES R EYNON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 04/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 PROSPECT ST T-509
KANSAS CITY MO
64132
US

IV. Provider business mailing address

6420 PROSPECT ST T-509
KANSAS CITY MO
64132
US

V. Phone/Fax

Practice location:
  • Phone: 816-276-4800
  • Fax: 816-523-1425
Mailing address:
  • Phone: 816-276-4800
  • Fax: 816-523-1425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberR9542
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0419333
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: