Individual
DR. MARY JO MIDDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4801 E LINWOOD BLVD, KANSAS CITY, MO 64128-2226
(816) 922-2740
Mailing address
16 WOODSON AVE, CAMDEN POINT, MO 64018-9153
(816) 617-2652
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD100493
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206650517
—
MO
Enumeration date
09/26/2006
Last updated
01/28/2010
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