Provider Demographics
NPI:1255389920
Name:DRAKE, WILLIAM BAKER III (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BAKER
Last Name:DRAKE
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:4150 N MULBERRY DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-1779
Mailing Address - Country:US
Mailing Address - Phone:816-584-0505
Mailing Address - Fax:816-265-6333
Practice Address - Street 1:4150 N MULBERRY DR
Practice Address - Street 2:SUITE 150
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-1779
Practice Address - Country:US
Practice Address - Phone:816-584-0505
Practice Address - Fax:816-265-6333
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2018-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO1198622080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204834204Medicaid
MO204834204Medicaid
MO269A384Medicare ID - Type Unspecified