Provider Demographics
NPI:1457615635
Name:MCGONIGLE, ERIN A (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:A
Last Name:MCGONIGLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7450 KESSLER ST STE 300
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2550
Mailing Address - Country:US
Mailing Address - Phone:913-632-2900
Mailing Address - Fax:913-632-2999
Practice Address - Street 1:7450 KESSLER ST STE 300
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2550
Practice Address - Country:US
Practice Address - Phone:913-632-2900
Practice Address - Fax:913-632-2999
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012020294207Q00000X
KS38069207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine