Provider Demographics
NPI:1447343835
Name:TICKLES, DEBRA F (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:F
Last Name:TICKLES
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:8919 PARALLEL PKWY
Mailing Address - Street 2:SUITE 380
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-1636
Mailing Address - Country:US
Mailing Address - Phone:913-299-8300
Mailing Address - Fax:913-299-9402
Practice Address - Street 1:8919 PARALLEL PKWY
Practice Address - Street 2:SUITE 380
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1636
Practice Address - Country:US
Practice Address - Phone:913-299-8300
Practice Address - Fax:913-299-9402
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0421633208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
12972021OtherBCBS KANSAS CITY
KS625991OtherBCBS KANSAS