Provider Demographics
NPI:1306093059
Name:RICCI, WALTER FRANCISCO (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:FRANCISCO
Last Name:RICCI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4350 SHAWNEE MISSION PKWY
Mailing Address - Street 2:SUITE 252
Mailing Address - City:FAIRWAY
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2507
Mailing Address - Country:US
Mailing Address - Phone:913-677-3399
Mailing Address - Fax:913-897-4317
Practice Address - Street 1:4350 SHAWNEE MISSION PKWY
Practice Address - Street 2:SUITE 252
Practice Address - City:FAIRWAY
Practice Address - State:KS
Practice Address - Zip Code:66205-2507
Practice Address - Country:US
Practice Address - Phone:913-677-3399
Practice Address - Fax:913-897-4317
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-147652084P0015X
MO333252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine