Healthcare Provider Details

I. General information

NPI: 1528599016
Provider Name (Legal Business Name): QUINTON D PALMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2017
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5844 NW BARRY RD STE 270
KANSAS CITY MO
64154-1466
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 501-686-5162
  • Fax:
Mailing address:
  • Phone: 913-491-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2020019607
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: