Provider Demographics
NPI:1942477054
Name:OCHOA, EMILY JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:JEAN
Last Name:OCHOA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:JEAN
Other - Last Name:HORNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:816-599-9499
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:4400 BROADWAY BLVD STE 400
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3342
Practice Address - Country:US
Practice Address - Phone:816-932-4500
Practice Address - Fax:816-932-4635
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-35668207N00000X
MO2012013473207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1942477054Medicaid
MO1942477054Medicaid
KSW19A00080Medicare PIN