MEDICARE: DR. KEVIN EUGENE FARRELL 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
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	DO 113250	MO

General Provider Information

NPI Number	:	1962409599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN EUGENE FARRELL D.O.

Provider Business Mailing Address
First Line	:	3014 OAK ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-3240
Country	:	US
Telephone Number	:	816-931-5594
Fax Number	:	816-931-9833

Provider Business Practice Location Address
First Line	:	3014 OAK ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-3240
Country	:	US
Telephone Number	:	816-931-5594
Fax Number	:	816-931-9833

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	08/26/2020

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