MEDICARE: KENT A HUSTON M.D.

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	207RR0500X	Rheumatology Physician	R7284	MO
2	207RR0500X	Rheumatology Physician	04-17252	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	37491	OTHER	KS	BCBS
2	06608037	OTHER	MO	BCBS

General Provider Information

NPI Number	:	1215999412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENT A HUSTON M.D.

Provider Business Mailing Address
First Line	:	4330 WORNALL RD
Second Line	:	MED PLAZA II, 4TH FLOOR
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3217
Country	:	US
Telephone Number	:	816-531-0930
Fax Number	:	816-753-2671

Provider Business Practice Location Address
First Line	:	4330 WORNALL RD
Second Line	:	MED PLAZA II, 4TH FLOOR
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3217
Country	:	US
Telephone Number	:	816-531-0930
Fax Number	:	816-753-2671

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

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	07/08/2007

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Directions to “ KENT A HUSTON M.D.” Practice Location

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