Provider Demographics
NPI:1679128516
Name:DELOZIER, ANDI (CNIM, REEGT)
Entity Type:Individual
Prefix:
First Name:ANDI
Middle Name:
Last Name:DELOZIER
Suffix:
Gender:F
Credentials:CNIM, REEGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17702 MISSION RDG
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64089-8003
Mailing Address - Country:US
Mailing Address - Phone:480-567-2742
Mailing Address - Fax:
Practice Address - Street 1:8929 PARALLEL PKWY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1689
Practice Address - Country:US
Practice Address - Phone:913-596-4000
Practice Address - Fax:903-328-6568
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-07
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic