Healthcare Provider Details

I. General information

NPI: 1396712071
Provider Name (Legal Business Name): ADAM BUHMAN-WIGGS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 FAR WEST DR STE 105
SAINT JOSEPH MO
64506-3514
US

IV. Provider business mailing address

5301 FARAON ST STE 120
SAINT JOSEPH MO
64506-3512
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-8133
  • Fax: 816-271-8349
Mailing address:
  • Phone: 816-271-8133
  • Fax: 816-271-8134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1190
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2000171097
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: