Provider Demographics
NPI:1104837640
Name:BAUMFALK, RAMONA L (OD)
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:L
Last Name:BAUMFALK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11261 NALL AVE
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1669
Mailing Address - Country:US
Mailing Address - Phone:913-261-2020
Mailing Address - Fax:913-261-2090
Practice Address - Street 1:4320 WORNALL RD
Practice Address - Street 2:SUITE 220
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5941
Practice Address - Country:US
Practice Address - Phone:913-261-2020
Practice Address - Fax:913-261-2090
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1801152W00000X
MO20080008323152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO405H00009Medicare PIN
MO405A00010Medicare PIN
KS405E00012Medicare PIN
MO405D00009Medicare PIN