Provider Demographics
NPI:1073585337
Name:CHILTON, JONATHAN D (M D)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:D
Last Name:CHILTON
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2330 E MEYER BLVD
Mailing Address - Street 2:SUITE T411
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1132
Mailing Address - Country:US
Mailing Address - Phone:816-363-2500
Mailing Address - Fax:816-363-8741
Practice Address - Street 1:2330 E MEYER BLVD
Practice Address - Street 2:SUITE T411
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1132
Practice Address - Country:US
Practice Address - Phone:816-363-2500
Practice Address - Fax:816-363-8741
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-25090207T00000X
MOR7H64207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202582508Medicaid
KS100141030AMedicaid
KS100141030AMedicaid
MO2797304Medicare ID - Type Unspecified