Provider Demographics
NPI:1114118361
Name:TON, DIANA NGOC (DPM)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:NGOC
Last Name:TON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:676 SE BAYBERRY LN
Mailing Address - Street 2:101
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-4389
Mailing Address - Country:US
Mailing Address - Phone:816-434-5906
Mailing Address - Fax:816-434-5907
Practice Address - Street 1:676 SE BAYBERRY LN
Practice Address - Street 2:101
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-4389
Practice Address - Country:US
Practice Address - Phone:816-434-5906
Practice Address - Fax:816-434-5907
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2009033094213E00000X
KS12-00375213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO43434025OtherBCBS/ANTHEM
MOMA3402001Medicare PIN