Provider Demographics
NPI:1386852127
Name:MCNERNEY, THOMAS PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PATRICK
Last Name:MCNERNEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 NW VIVION RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4555
Mailing Address - Country:US
Mailing Address - Phone:816-746-9045
Mailing Address - Fax:816-734-9035
Practice Address - Street 1:1402 NW VIVION RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4555
Practice Address - Country:US
Practice Address - Phone:816-746-9045
Practice Address - Fax:816-734-9035
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000167943111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MODE870005OtherEMPLOYER NUMBER
MO29808015OtherBLUE CROSS BLUE SHIELD
MO18104711OtherMO TAX NUMBER