Provider Demographics
NPI:1972641629
Name:NORTON, KENNETH ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:ALLEN
Last Name:NORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 W 74TH ST STE 333
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2222
Mailing Address - Country:US
Mailing Address - Phone:913-262-9311
Mailing Address - Fax:913-262-7374
Practice Address - Street 1:8901 W 74TH ST STE 333
Practice Address - Street 2:
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2222
Practice Address - Country:US
Practice Address - Phone:913-262-9311
Practice Address - Fax:913-262-7374
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS16825207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1164066Medicare PIN
KSC50978Medicare UPIN
KS827113112Medicare PIN
KS1160000Medicare PIN