Provider Demographics
NPI:1598859183
Name:WILLIAMSON, STEPHEN K (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:K
Last Name:WILLIAMSON
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 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:SUITE 210, MS 5003
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-6029
Mailing Address - Fax:913-588-4085
Practice Address - Street 1:2330 SHAWNEE MISSION PKWY
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-2005
Practice Address - Country:US
Practice Address - Phone:913-588-7750
Practice Address - Fax:913-588-8766
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-19904207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO12507045OtherBCBS KC
KS627430OtherFIRSTGUARD
KS100203590AMedicaid
MO202035515Medicaid
MO12507045OtherBCBS KC
KS110121125Medicare ID - Type UnspecifiedRAILROAD MEDICARE
KS0115183AMedicare ID - Type Unspecified