Provider Demographics
NPI:1225033889
Name:CAMERON, JEFFREY W (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:W
Last Name:CAMERON
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 1:10730 NALL AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1366
Mailing Address - Country:US
Mailing Address - Phone:913-754-2800
Mailing Address - Fax:913-754-2899
Practice Address - Street 1:10730 NALL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1366
Practice Address - Country:US
Practice Address - Phone:913-754-2800
Practice Address - Fax:913-754-2899
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO102326208600000X, 2086S0129X
KS04265082086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G49711Medicare UPIN
KS5909874AMedicare ID - Type Unspecified
MO5909874Medicare ID - Type Unspecified