Provider Demographics
NPI:1093713703
Name:KIRBY-DIAZ, CINDY L (MD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:L
Last Name:KIRBY-DIAZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:205 W R D MIZE RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-2518
Mailing Address - Country:US
Mailing Address - Phone:816-228-4770
Mailing Address - Fax:816-228-1156
Practice Address - Street 1:205 W R D MIZE RD
Practice Address - Street 2:SUITE 304
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-2518
Practice Address - Country:US
Practice Address - Phone:816-228-4770
Practice Address - Fax:816-228-1156
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO200102696208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
049924OtherFAMILY HEALTH PARTNERS
049993OtherFAMILY HEALTH PARTNERS
MO209232222Medicaid
33514022OtherBLUE CROSS/BLUE SHIELD
1201847OtherUNITED HEALTH CARE
7354357OtherAETNA
502062OtherFIRST GUARD