Individual
DR. ANTONETTE CONSUELO ACOSTA-DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6450 N CHATHAM AVE, KANSAS CITY, MO 64151
(816) 741-5542
(816) 746-4262
Mailing address
9411 N OAK TRFY, SUITE LL1, KANSAS CITY, MO 64155-2262
(816) 436-7072
(816) 436-2743
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2003017244
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33205014
BCBS OF KC INDIVIDUAL #
—
01
—
P00134132
RAILROAD MEDICARE
—
Enumeration date
01/30/2006
Last updated
02/20/2013
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