Provider Demographics
NPI:1477507002
Name:EYNON, JAMES R (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:EYNON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6420 PROSPECT ST
Mailing Address - Street 2:T-509
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132
Mailing Address - Country:US
Mailing Address - Phone:816-276-4800
Mailing Address - Fax:816-523-1425
Practice Address - Street 1:6420 PROSPECT ST
Practice Address - Street 2:T-509
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132
Practice Address - Country:US
Practice Address - Phone:816-276-4800
Practice Address - Fax:816-523-1425
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9542207RC0000X
KS0419333207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
08010011OtherBLUE SHIELD OF KC HMO
0007908025OtherAETNA HMO
060013885OtherMEDICARE RAILROAD
08010011OtherPHP FREEDOM
431092652A014OtherCHAMPUS TRICARE
08010011OtherBLUE SHEILD OF KC PPO
0007908025OtherAETNA
0007908025OtherAETNA PPO
08010011OtherBLUE SHIELD OF KC HMO
MO4544235AMedicare ID - Type Unspecified