Healthcare Provider Details
I. General information
NPI: 1497725543
Provider Name (Legal Business Name): KENNETH PAUL DUNCAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/23/2006
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2700 CLAY EDWARDS DR SUITE 500
NORTH KANSAS CITY MO
64116-3251
US
IV. Provider business mailing address
9411 N OAK TRFY SUITE LL1
KANSAS CITY MO
64155-2262
US
V. Phone/Fax
- Phone: 816-421-4115
- Fax: 816-421-4152
- Phone: 816-436-7072
- Fax: 816-436-2743
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | R2E10 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: