Individual
DR. CORY TYSON CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10787 NALL AVE STE 310, OVERLAND PARK, KS 66211-1301
(913) 945-6900
(913) 946-6970
Mailing address
10787 NALL AVE STE 310, OVERLAND PARK, KS 66211-1301
(913) 945-6900
(913) 945-6970
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
05-47099
KS
207R00000X
Internal Medicine Physician
2015014048
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679833800
—
MO
Enumeration date
05/22/2012
Last updated
04/04/2023
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