Provider Demographics
NPI:1255306189
Name:WOLOCK, BARBARA D (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:D
Last Name:WOLOCK
Suffix:
Gender:F
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:PO BOX 219241
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64121-9241
Mailing Address - Country:US
Mailing Address - Phone:913-829-5511
Mailing Address - Fax:913-829-5571
Practice Address - Street 1:21020 W 151ST ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7200
Practice Address - Country:US
Practice Address - Phone:913-829-5511
Practice Address - Fax:913-829-5571
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0423830207W00000X
MOR3P32207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200381410AMedicaid
KS180036185OtherRAILROAD MEDICARE
F07501Medicare UPIN
KS200381410AMedicaid
KSK383090Medicare PIN