Provider Demographics
NPI:1952366692
Name:GARNER, ANGELA (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:GARNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11124 S AMINDA ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-7132
Mailing Address - Country:US
Mailing Address - Phone:816-822-0050
Mailing Address - Fax:816-817-1075
Practice Address - Street 1:106 W 11TH ST
Practice Address - Street 2:SUITE 1215
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64105-1813
Practice Address - Country:US
Practice Address - Phone:816-822-0050
Practice Address - Fax:816-817-1075
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005018781207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO263D906AMedicare ID - Type UnspecifiedMEDICARE NUMBER
MOI32285Medicare UPIN