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NPI Code Detail

MEDICARE: DR. KENNETH AARON SHAW D.O.

MEDICARE:  DR. KENNETH AARON SHAW  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
1207XP3100XPediatric Orthopaedic Surgery PhysicianT3546TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12023014623OTHERMOMISSOURI MEDICAL LICENSE
2T3546OTHERTXTEXAS MEDICAL LICENSE
305-47742OTHERKSKANSAS MEDICAL LICENSE

General Provider Information

NPI Number : 1316387392
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH AARON SHAW D.O.
Provider Business Mailing Address
First Line : 2401 GILLHAM RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 816-701-5200
Fax Number :
Provider Business Practice Location Address
First Line : 2401 GILLHAM RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 816-710-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2013
Last Update Date : 09/05/2023

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