Provider Demographics
NPI:1285677732
Name:VORAN, DAVID AVERY (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:AVERY
Last Name:VORAN
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 1:2703 RUNNING HORSE ROAD
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079
Mailing Address - Country:US
Mailing Address - Phone:816-858-7050
Mailing Address - Fax:816-858-7056
Practice Address - Street 1:7900 LEES SUMMIT RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64139-1236
Practice Address - Country:US
Practice Address - Phone:816-404-7000
Practice Address - Fax:816-404-7756
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-22847207Q00000X
MO2001000305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100127170DMedicaid
MO208634220Medicaid
MO26300044AOtherMEDICARE (UNIVERSITY PHYSICIANS ASSOCIATED)
MO208634212Medicaid
MOP00628592OtherRR MEDICARE
MO208634220Medicaid
MO7012663Medicare PIN
MOP00108297Medicare ID - Type UnspecifiedRAILROAD MEDICARE-GOPPERT
KSV0502166Medicaid
MO2292663Medicare ID - Type Unspecified
KS20-502106-02Medicaid
MOE56874Medicare UPIN
MO208634220Medicaid