Provider Demographics
NPI:1275540775
Name:WILLHOITE, DOUGLAS J (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:J
Last Name:WILLHOITE
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 1:4000 CAMBRIDGE ST STE G600
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8501
Mailing Address - Country:US
Mailing Address - Phone:913-588-9600
Mailing Address - Fax:
Practice Address - Street 1:4000 CAMBRIDGE ST STE G600
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-9600
Practice Address - Fax:913-588-9770
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6F72207RC0000X
KS04-22093207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS051564OtherBCBS KS OUTREACH CLINICS
KS100127760AMedicaid
12563046OtherBCBS KC
KS100127760BMedicaid
MO202262614Medicaid
MO202262614Medicaid
KS051564OtherBCBS KS OUTREACH CLINICS
KS100127760AMedicaid
KS060062395Medicare PIN
C50777Medicare UPIN
KS100127760BMedicaid
12563046OtherBCBS KC