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Individual

DR. BLAIR ASHTON THEDINGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3515 BROADWAY ST, KANSAS CITY, MO 64111-2537
(816) 753-5144
(816) 756-1081
Mailing address
3515 BROADWAY ST, KANSAS CITY, MO 64111-2537
(816) 753-5144
(816) 756-1081

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
04-36367
KS
207Q00000X
Family Medicine Physician
Primary
2013033410
MO

Other

Enumeration date
03/30/2010
Last updated
09/10/2013
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