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WILLIAM ALBERT MOFFITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
3515 S 4TH STREET, PROFESSIONAL ASSOCIATION, LEAVENWORTH, KS 66048
(913) 651-8415
(913) 772-8580
Mailing address
18955 WEST 116TH STREET, OLATHE, KS 66061
(913) 888-2362

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
675
KS
103T00000X
Psychologist
R0333
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004517
GROUP BCBS
KS
01
066956
BCBS OF KS
KS
01
19924039
BCBS OF KC KS
KS
01
2008188
CIGNA
01
4285605
AETNA
01
B011
PHYSICIAN SERVICES TRICAR
WI
Enumeration date
09/13/2006
Last updated
07/08/2007
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