Provider Demographics
NPI:1659410231
Name:THORNTON, JULIE A
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:THORNTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7216 W 80TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-3718
Mailing Address - Country:US
Mailing Address - Phone:913-649-1851
Mailing Address - Fax:913-649-4715
Practice Address - Street 1:7216 W 80TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-3718
Practice Address - Country:US
Practice Address - Phone:913-649-1851
Practice Address - Fax:913-649-4715
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS5150830002Medicare ID - Type Unspecified