Individual
ELEANOR A LISBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3901 RAINBOW BLVD, 4070 DELP MAIL STOP 4010, KANSAS CITY, KS 66160
(913) 588-1908
Mailing address
3901 RAINBOW BLVD, 4070 DELP MAIL STOP 4010, KANSAS CITY, KS 66160
(913) 588-1908
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-24164
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080163323
RAILROAD MEDICARE
—
05
—
100376460A
—
KS
01
—
19883028
BCBS KANSAS CITY
MO
05
—
205169600
—
MO
01
—
372961
FIRSTGUARD
KS
Enumeration date
10/04/2006
Last updated
09/20/2010
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