Organization
WYANDOTTE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA F TICKLES M.D. (OWNER)
(913) 299-8300
Entity
Organization
Contact information
Practice address
8919 PARALLEL PKWY, SUITE 380, KANSAS CITY, KS 66112-1636
(913) 299-3800
(913) 299-9402
Mailing address
8919 PARALLEL PKWY, SUITE 380, KANSAS CITY, KS 66112-1636
(913) 299-3800
(913) 299-9402
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14230011
BCBS KANSAS CITY
—
01
—
625989
BCBS KANSAS
KS
Enumeration date
09/30/2006
Last updated
08/22/2020
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