Provider Demographics
NPI:1013206051
Name:COWAN, KRISTOPHER L (DO)
Entity Type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:L
Last Name:COWAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 LEES SUMMIT RD
Mailing Address - Street 2:FAMILY MEDICINE RESIDENCY OFFICE
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64139-1236
Mailing Address - Country:US
Mailing Address - Phone:816-404-9030
Mailing Address - Fax:816-404-9001
Practice Address - Street 1:7900 LEES SUMMIT RD
Practice Address - Street 2:FAMILY MEDICINE RESIDENCY OFFICE
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64139-1236
Practice Address - Country:US
Practice Address - Phone:816-404-9030
Practice Address - Fax:816-404-9001
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program