Provider Demographics
NPI:1720072564
Name:WEBB, JOHN M (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:WEBB
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 1:6400 PROSPECT AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1100
Mailing Address - Country:US
Mailing Address - Phone:816-276-9100
Mailing Address - Fax:816-276-9101
Practice Address - Street 1:6400 PROSPECT AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1100
Practice Address - Country:US
Practice Address - Phone:816-276-9100
Practice Address - Fax:816-276-9101
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO346162086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100124350BMedicaid
KS100124350 CMedicaid
MO202950200Medicaid
MO202950200Medicaid
MOT413729Medicare PIN
MOP00417223Medicare PIN