Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 94-07372 | KS |
NPI | 1013236934 |
---|---|
Provider Name | O. Layton Alldredge JR. |
First Address | Kansas City, KS 66160-0001 |
Second Address | Kansas City, KS 66160-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2010 |
Last Update Date | 18/05/2010 |