Healthcare Provider Details

I. General information

NPI: 1275557878
Provider Name (Legal Business Name): JAMIE SUE HONEYCUTT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE SUE PROFFITT MD

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 WOLLARD BLVD
RICHMOND MO
64085
US

IV. Provider business mailing address

420 WOLLARD BLVD
RICHMOND MO
64085-1974
US

V. Phone/Fax

Practice location:
  • Phone: 816-470-2131
  • Fax: 816-470-7171
Mailing address:
  • Phone: 816-470-2131
  • Fax: 816-470-7171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number2006012802
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2006012802
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: