Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 04-12579 | KS |
NPI | 1053414946 |
---|---|
Provider Name | Joseph L Kyner |
First Address | Kansas City, KS 66160 |
Second Address | Kansas City, KS 66160 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05124031 | BCBS KC (01) | MO |
626300 | FIRSTGUARD (01) | KS |
C50678 | (02) |