Provider Demographics
NPI:1568462992
Name:TAYLOR-BUTLER, KENNETH LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:LAWRENCE
Last Name:TAYLOR-BUTLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KENNETH
Other - Middle Name:LAWRENCE
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:301 E ARMOUR BLVD
Mailing Address - Street 2:STE 2E
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-1289
Mailing Address - Country:US
Mailing Address - Phone:913-495-2221
Mailing Address - Fax:913-495-2201
Practice Address - Street 1:301 E ARMOUR BLVD
Practice Address - Street 2:STE 2E
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-1289
Practice Address - Country:US
Practice Address - Phone:913-495-2221
Practice Address - Fax:913-495-2201
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0423290207Q00000X
MO106989207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207858705Medicaid
MO207858705Medicaid