Healthcare Provider Details

I. General information

NPI: 1205241973
Provider Name (Legal Business Name): MEGHAN BLAY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2014
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 SW 3RD ST
LEES SUMMIT MO
64063-2212
US

IV. Provider business mailing address

8550 MARSHALL DR STE 220
LENEXA KS
66214-9836
US

V. Phone/Fax

Practice location:
  • Phone: 816-524-3799
  • Fax: 913-495-3727
Mailing address:
  • Phone: 816-524-3799
  • Fax: 913-495-3727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2014019173
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: