Healthcare Provider Details

I. General information

NPI: 1649563024
Provider Name (Legal Business Name): KELSEY ANNE FLYNT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2011
Last Update Date: 11/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 NW BARRY RD STE 100
KANSAS CITY MO
64154-2578
US

IV. Provider business mailing address

901 E. 104TH ST MAILSTOP 400N
KANSAS CITY MO
64131
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-5350
  • Fax: 816-932-5842
Mailing address:
  • Phone: 816-502-8752
  • Fax: 816-932-9670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4301100185
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: