1720101652 NPI number — DR. BRIAN TODD ALLENBRAND M.D.

Table of content: DR. BRIAN TODD ALLENBRAND M.D. (NPI 1720101652)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720101652 NPI number — DR. BRIAN TODD ALLENBRAND M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLENBRAND
Provider First Name:
BRIAN
Provider Middle Name:
TODD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720101652
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 E. 104TH ST.
Provider Second Line Business Mailing Address:
MAILSTOP 400N
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-502-7104
Provider Business Mailing Address Fax Number:
816-932-9670

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5844 NW BARRY RD
Provider Second Line Business Practice Location Address:
SUITE 270
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64154-1465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-880-2600
Provider Business Practice Location Address Fax Number:
816-880-2640
Provider Enumeration Date:
04/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X , with the licence number:  2011003919 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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