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General NPI Number Information
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NPI Number | 1528083078
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Entity Type | Individual
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Provider Name | RODERICK WARREN MD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 800 RAVENHILL DR STE 100&107
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City | ATCHISON
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State | KS
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Zip | 66002-9204
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Country | US
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Telephone | 913-674-2340
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Fax | 913-674-2039
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Provider Business Mailing Address
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Address Line | 810 RAVENHILL DR
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City | ATCHISON
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State | KS
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Zip | 66002-9204
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Country | US
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Telephone | 913-674-2340
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Fax | 913-674-2039
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 22487
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0428647
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License Number State | KS
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