Deetra Yelena Ford
Internist Neurologist
3901 Rainbow Blvd
Kansas City
, Kansas 66160-8500
Deetra Yelena Ford
Internist Neurologist
3901 Rainbow Blvd
Kansas City
, Kansas 66160-8500
(913) 945-8700
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About
Features
Specialties
- Internist
- Neurologist
Languages spoken
- English
Location
First Address
- Deetra Yelena Ford
- 3901 Rainbow Blvd
- Kansas City, KS
- Zip : 66160-8500
- Phone : (913) 945-8700
Second Address
- Deetra Yelena Ford
- 3901 Rainbow Blvd
- Kansas City, KS
- Zip : 66160-8500
- Phone : (913) 945-8700
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | 946742 | KS |
| N | 111NI0900X | Internist | 946742 | KS |
| Y | 2084N0400X | Neurologist | 2011021426 | MO |
National Provider Identifier
| NPI | 1023214129 |
|---|---|
| Provider Name | Deetra Yelena Ford |
| First Address | Kansas City, KS 66160-8500 |
| Second Address | Kansas City, KS 66160-8500 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/06/2007 |
| Last Update Date | 25/07/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1023214129 | (05) | MO |
| 200743370A | (05) | KS |
| P00991358 | RR MEDICARE (01) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.