Provider Demographics
NPI:1215999412
Name:HUSTON, KENT A (MD)
Entity type:Individual
Prefix:
First Name:KENT
Middle Name:A
Last Name:HUSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 WORNALL RD
Mailing Address - Street 2:MED PLAZA II, 4TH FLOOR
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3217
Mailing Address - Country:US
Mailing Address - Phone:816-531-0930
Mailing Address - Fax:816-753-2671
Practice Address - Street 1:4330 WORNALL RD
Practice Address - Street 2:MED PLAZA II, 4TH FLOOR
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3217
Practice Address - Country:US
Practice Address - Phone:816-531-0930
Practice Address - Fax:816-753-2671
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7284207RR0500X
KS04-17252207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS37491OtherBCBS
MO06608037OtherBCBS
MO06608037OtherBCBS
6143663Medicare ID - Type Unspecified