Provider Demographics
NPI:1295097194
Name:HERR, CAMERON CODY LYNN (DO, MBA)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:CODY LYNN
Last Name:HERR
Suffix:
Gender:M
Credentials:DO, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6185 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152
Mailing Address - Country:US
Mailing Address - Phone:816-880-2600
Mailing Address - Fax:816-880-2640
Practice Address - Street 1:6185 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MO
Practice Address - Zip Code:64152
Practice Address - Country:US
Practice Address - Phone:816-880-2600
Practice Address - Fax:816-880-2640
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012018918207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism