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General NPI Number Information
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NPI Number | 1720234107
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Entity Type | Individual
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Provider Name | CECILY ANNE CLARK-GANHEART MD
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Gender | Female
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Dates
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Enumeration Date | 08/17/2008
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 3901 RAINBOW BLVD # MS 2028
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City | KANSAS CITY
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State | KS
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Zip | 66160-8500
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Country | US
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Telephone | 913-588-6201
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Fax | 913-588-6271
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Provider Business Mailing Address
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Address Line | 13101 HEMLOCK ST
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City | OVERLAND PARK
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State | KS
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Zip | 66213-2738
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Country | US
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Telephone | 269-209-2048
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD040474
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ABCDEFG1
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 2015021377
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 0438153
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License Number State | KS
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