1518076728 NPI number — EDWARD B. TOBY M.D.

Table of content: EDWARD B. TOBY M.D. (NPI 1518076728)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518076728 NPI number — EDWARD B. TOBY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOBY
Provider First Name:
EDWARD
Provider Middle Name:
B.
Provider Name Prefix Text:
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:
1518076728
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3901 RAINBOW BLVD.
Provider Second Line Business Mailing Address:
MS 4070 DELP
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66160-7816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-588-6100
Provider Business Mailing Address Fax Number:
913-588-8186

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3901 RAINBOW BLVD
Provider Second Line Business Practice Location Address:
ORTHOPEDIC SURGERY MS 3017
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-588-6100
Provider Business Practice Location Address Fax Number:
913-588-8186
Provider Enumeration Date:
08/30/2006

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: 207X00000X , with the licence number:  04-23638 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XS0106X , with the licence number: 04-23638 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 17553046 . This is a "BCBS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 200023625 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 627210 . This is a "FIRSTGUARD OF KANSAS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 203061908 . This is a "MISSOURI MEDICAID" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 100126860A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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