Provider Demographics
NPI:1073511507
Name:DECKER, RICHARD KENT (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:KENT
Last Name:DECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 W. 75TH STREET
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204
Mailing Address - Country:US
Mailing Address - Phone:913-384-5500
Mailing Address - Fax:913-384-5209
Practice Address - Street 1:8800 W. 75TH STREET
Practice Address - Street 2:SUITE 220
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204
Practice Address - Country:US
Practice Address - Phone:913-384-5500
Practice Address - Fax:913-384-5209
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0419984208000000X
MOR3E01208000000X
KS04-19984208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics