Provider Demographics
NPI:1679531891
Name:DAVIS, KAROL L (MD)
Entity Type:Individual
Prefix:
First Name:KAROL
Middle Name:L
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5675 ROE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:ROELAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2538
Mailing Address - Country:US
Mailing Address - Phone:913-432-2080
Mailing Address - Fax:913-432-5183
Practice Address - Street 1:2040 HUTTON RD
Practice Address - Street 2:SUITE 102
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66109-4566
Practice Address - Country:US
Practice Address - Phone:913-299-3700
Practice Address - Fax:913-299-3050
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-05-21
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Provider Licenses
StateLicense IDTaxonomies
KS0430346207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200357860AMedicaid
KS100216770CMedicaid
KS100216770CMedicaid
KSF20D344Medicare PIN
KSF44162Medicare UPIN