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Individual

DR. KENNETH ROSS MANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2700 CLAY EDWARDS DR, SUITE 400, NORTH KANSAS CITY, MO 64116-3251
(816) 421-4240
(816) 421-5015
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
207R00000X
Internal Medicine Physician
Primary
MDR8C71
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10278054
BCBS OF KC INDIVIDUAL #
01
110078052
RAILROAD MEDICARE
05
202339701
MO
Enumeration date
02/07/2006
Last updated
10/24/2007
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