Healthcare Provider Details
I. General information
NPI: 1730308552
Provider Name (Legal Business Name): ALAN ZONNO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/24/2007
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 NE SAINT LUKES BLVD SUITE 200
LEES SUMMIT MO
64086-6011
US
IV. Provider business mailing address
901 E 104TH ST
KANSAS CITY MO
64131-4517
US
V. Phone/Fax
- Phone: 816-246-4302
- Fax: 816-246-8910
- Phone: 816-502-8752
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 2014026477 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0801X |
| Taxonomy | Orthopaedic Trauma Physician |
| License Number | 2014026477 |
| License Number State | MO |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XX0004X |
| Taxonomy | Orthopaedic Foot and Ankle Surgery Physician |
| License Number | 2014026477 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: