MEDICARE: KENNETH LAN MD

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	2021031340	MO

General Provider Information

NPI Number	:	1316439169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH LAN MD

Provider Business Mailing Address
First Line	:	2330 E MEYER BLVD STE 101
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-1140
Country	:	US
Telephone Number	:	816-276-9800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2330 E MEYER BLVD STE 101
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-1140
Country	:	US
Telephone Number	:	816-276-9800
Fax Number	:

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

Provider Enumeration Date	:	06/06/2018
Last Update Date	:	09/01/2022

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Directions to “ KENNETH LAN MD” Practice Location

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