Provider Demographics
NPI:1790828002
Name:SHARP, ELMER WAYNE (DC)
Entity Type:Individual
Prefix:
First Name:ELMER
Middle Name:WAYNE
Last Name:SHARP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3214 STRONG AVENUE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66106
Mailing Address - Country:US
Mailing Address - Phone:913-831-2661
Mailing Address - Fax:913-831-6297
Practice Address - Street 1:3214 STRONG AVENUE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66106
Practice Address - Country:US
Practice Address - Phone:913-831-2661
Practice Address - Fax:913-831-6297
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0103185111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO02536014POtherBCBS MO
KS067750OtherBCBS KS
KS0003148AMedicare ID - Type Unspecified