Provider Demographics
NPI:1043218415
Name:ROSENTHAL, WILLIAM N (MDFACS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:N
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:MDFACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843330
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184
Mailing Address - Country:US
Mailing Address - Phone:913-663-5900
Mailing Address - Fax:913-663-5902
Practice Address - Street 1:10740 NALL AVENUE
Practice Address - Street 2:SUITE 220
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211
Practice Address - Country:US
Practice Address - Phone:913-663-5900
Practice Address - Fax:913-663-5902
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36399207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO14593019OtherBLUECROSS KANSAS CITY
KS180041080OtherRAILROAD MEDICARE PIN
KS495486OtherBLUE CROSS KANSAS
MO180011639OtherMEDICARE RAILROAD PIN
KSF320000Medicare PIN
KS047547Medicare PIN
KS495486OtherBLUE CROSS KANSAS
KSF320319Medicare ID - Type Unspecified
MOE24109Medicare UPIN
MO1440319Medicare ID - Type Unspecified