Individual
STEPHEN L THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4000 CAMBRIDGE STREET 4045B DELP, KANSAS CITY, KS 66160
(913) 914-6088
Mailing address
12784 ABERDEEN CT, LEAWOOD, KS 66209-2454
(599) 940-0421
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
04-31362
KS
207P00000X
Emergency Medicine Physician
2005011352
MO
207P00000X
Emergency Medicine Physician
A80775
CA
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
04-31362
KS
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
2005011352
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200366630A
—
KS
05
—
202299129
—
MO
01
—
481202402
PSKU TAX ID
—
01
—
7990888
AETNA PSKU
—
Enumeration date
08/01/2006
Last updated
07/08/2019
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