Provider Demographics
NPI:1598724726
Name:ALFORD, KELLY RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:RENEE
Last Name:ALFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6530 TROOST
Mailing Address - Street 2:STE A
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:816-361-0670
Mailing Address - Fax:816-444-6936
Practice Address - Street 1:6530 TROOST
Practice Address - Street 2:STE A
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131
Practice Address - Country:US
Practice Address - Phone:816-361-0670
Practice Address - Fax:816-444-6936
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2004007601207RN0300X
KS0429622207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
129D207Medicare ID - Type Unspecified
I12626Medicare UPIN