MEDICARE: DR. WILLIAM F SUDHOLT D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	2005039937	MO
2	207R00000X	Internal Medicine Physician	05-32227	KS

General Provider Information

NPI Number	:	1164486254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM F SUDHOLT D.O.

Provider Business Mailing Address
First Line	:	201 NW R D MIZE RD # 214
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2513
Country	:	US
Telephone Number	:	816-655-5780
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 NW R D MIZE RD STE 206
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2513
Country	:	US
Telephone Number	:	816-655-5403
Fax Number	:	816-655-5257

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	11/10/2025

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