Individual
RODERICK WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 RAVENHILL DR STE 100&107, ATCHISON, KS 66002-9204
(913) 674-2340
(913) 674-2039
Mailing address
800 RAVENHILL DR, ATCHISON, KS 66002-9204
(913) 367-2131
(913) 674-2023
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
22487
KS
208600000X
Surgery Physician
Primary
0428647
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100458720D
—
KS
01
—
103525
BLUE CROSS OF KS
KS
01
—
16289068
PTAN
—
05
—
209411602
—
MO
05
—
30004305590002
—
KS
Enumeration date
07/13/2006
Last updated
03/19/2026
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