Provider Demographics
NPI:1295113561
Name:PRESLEY, TERRY LEE JR (DO)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:LEE
Last Name:PRESLEY
Suffix:JR
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:PO BOX 803345
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-0909
Mailing Address - Country:US
Mailing Address - Phone:816-459-7500
Mailing Address - Fax:816-459-9611
Practice Address - Street 1:2790 CLAY EDWARDS DR STE 650
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3279
Practice Address - Country:US
Practice Address - Phone:816-459-7500
Practice Address - Fax:816-459-9611
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY04758207X00000X
MO2021024886207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100683400Medicaid
IN300041810Medicaid
MO200101231Medicaid