Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 04-19849 | KS |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 110638 | MO |
N | 2086S0120X | Pediatric Surgery | 110638 | MO |
NPI | 1316997786 |
---|---|
Provider Name | Dr. Bradford Olney |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 09/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100126420F | (05) | KS |
202596417 | (05) | MO |
E65676 | (02) |