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General NPI Number Information
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NPI Number | 1114019593
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Entity Type | Individual
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Provider Name | LORI ANN GOLON MD
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 1001 6TH AVE STE 210
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City | LEAVENWORTH
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State | KS
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Zip | 66048-3248
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Country | US
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Telephone | 913-682-3920
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Fax | 913-682-6239
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Provider Business Mailing Address
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Address Line | 19800 METCALF AVE UNIT 36
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City | STILWELL
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State | KS
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Zip | 66085-2602
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Country | US
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Telephone | 913-379-2266
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Fax | 877-673-6823
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0428097
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License Number State | KS
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