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Individual

DR. GERALD K. GENTRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
302 E PARK ST, OLATHE, KS 66061-5408
(816) 374-3838
(913) 782-4214
Mailing address
302 E PARK ST, OLATHE, KS 66061-5408
(816) 374-3838
(913) 782-4214

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP508
KS
103T00000X
Psychologist
R0070 (INACTIVE)
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08364020
BC-BS OF KANSAS CITY
KS
01
119836
BC-BS OF KANSAS
KS
Enumeration date
05/17/2007
Last updated
07/08/2007
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