Provider Demographics
NPI:1891799557
Name:CHASE, WILLIAM MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MARTIN
Last Name:CHASE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9040 QUIVIRA RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-3902
Mailing Address - Country:US
Mailing Address - Phone:913-944-4900
Mailing Address - Fax:
Practice Address - Street 1:9040 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3902
Practice Address - Country:US
Practice Address - Phone:913-944-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6D102085R0202X
KS04-258962085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100153560BMedicaid
MO202351847Medicaid
KS100153560CMedicaid
KSJ965999AMedicare PIN
MO202351847Medicaid
KSO57888Medicare PIN
MOJ965999Medicare PIN