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Individual
THEODORE J FELTS
Active
Individual
THEODORE J FELTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-26778
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100301780G
—
KS
05
—
100301780K
—
KS
05
—
100301780M
—
KS
05
—
1861436347
—
MO
01
—
22488110
BLUE SHIELD KC, MO
MO
01
—
P00338240
RAILROAD MEDICARE
—
Enumeration date
06/15/2006
Last updated
04/19/2023
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