Provider Demographics
NPI:1770541542
Name:DUGGAN, EILEEN (MD)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:EILEEN
Other - Middle Name:DUGGAN
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10918 ELM AVENUE
Mailing Address - Street 2:CRITTTENTON CHILDRENS CENTER
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64134
Mailing Address - Country:US
Mailing Address - Phone:816-765-6600
Mailing Address - Fax:816-767-4159
Practice Address - Street 1:10918 ELM AVENUE
Practice Address - Street 2:CRITTTENTON CHILDRENS CENTER
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64134
Practice Address - Country:US
Practice Address - Phone:816-765-6600
Practice Address - Fax:816-767-4159
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMDR72722084P0804X
KS04147242084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E57302Medicare UPIN