Provider Demographics
NPI:1174966774
Name:EDWARDS, ALLISON (MD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 W 43RD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66103-3313
Mailing Address - Country:US
Mailing Address - Phone:913-730-0331
Mailing Address - Fax:913-553-4272
Practice Address - Street 1:2016 W 43RD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-3313
Practice Address - Country:US
Practice Address - Phone:913-730-0331
Practice Address - Fax:913-553-4272
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-12
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-38979207Q00000X
CODR.0055906207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty