MEDICARE: DR. KELLY RENEE ALFORD 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	207RN0300X	Nephrology Physician	2004007601	MO
2	207RN0300X	Nephrology Physician	0429622	KS

General Provider Information

NPI Number	:	1598724726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELLY RENEE ALFORD MD

Provider Business Mailing Address
First Line	:	6530 TROOST
Second Line	:	STE A
City	:	KANSAS CITY
State	:	MO
Zip	:	64131
Country	:	US
Telephone Number	:	816-361-0670
Fax Number	:	816-444-6936

Provider Business Practice Location Address
First Line	:	6530 TROOST
Second Line	:	STE A
City	:	KANSAS CITY
State	:	MO
Zip	:	64131
Country	:	US
Telephone Number	:	816-361-0670
Fax Number	:	816-444-6936

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

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	07/08/2007

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