Provider Demographics
NPI:1437653490
Name:ATHERTON, SAMUEL WALTON (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:WALTON
Last Name:ATHERTON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4401 WORNALL RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3220
Mailing Address - Country:US
Mailing Address - Phone:816-932-3679
Mailing Address - Fax:816-932-9089
Practice Address - Street 1:4401 WORNALL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3220
Practice Address - Country:US
Practice Address - Phone:816-932-3679
Practice Address - Fax:816-932-9089
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2023-10-16
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Provider Licenses
StateLicense IDTaxonomies
MO2023014678207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology