Healthcare Provider Details

I. General information

NPI: 1811001084
Provider Name (Legal Business Name): WILLIAM ALLEN POE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 NE SAINT LUKES BLVD
LEES SUMMIT MO
64086-6000
US

IV. Provider business mailing address

10310 STATE LINE RD STE A
LEAWOOD KS
66206-2695
US

V. Phone/Fax

Practice location:
  • Phone: 816-347-5800
  • Fax: 816-347-5899
Mailing address:
  • Phone: 913-647-4101
  • Fax: 913-647-4121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2003025743
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: