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NPI Code Detail

MEDICARE: DAVID MATTHEW WILLEY M.D.

MEDICARE: DAVID MATTHEW WILLEY 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
12084P0800XPsychiatry Physician04-37722KS

General Provider Information

NPI Number : 1629364807
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID MATTHEW WILLEY M.D.
Provider Business Mailing Address
First Line : 13351 S ARAPAHO DR
Second Line :
City : OLATHE
State : KS
Zip : 66062-1520
Country : US
Telephone Number : 913-353-3000
Fax Number : 913-353-3001
Provider Business Practice Location Address
First Line : 13351 S ARAPAHO DR
Second Line :
City : OLATHE
State : KS
Zip : 66062-1520
Country : US
Telephone Number : 913-353-3000
Fax Number : 913-353-3001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2011
Last Update Date : 01/31/2017

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