Provider Demographics
NPI:1649486523
Name:VETTER, TIFFANY ANN (MD)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:ANN
Last Name:VETTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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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:913-831-6880
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:913-831-6880
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059342207R00000X
KS04-34087207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine