Healthcare Provider Details

I. General information

NPI: 1073655585
Provider Name (Legal Business Name): KERRY JEAN WILLIAMS-WUCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5844 NW BARRY RD STE 40
KANSAS CITY MO
64154-1483
US

IV. Provider business mailing address

901 E 104TH ST # MS 400S
KANSAS CITY MO
64131-4517
US

V. Phone/Fax

Practice location:
  • Phone: 816-880-3876
  • Fax:
Mailing address:
  • Phone: 816-880-3876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number2006020988
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: