Basic Information
Provider Information
NPI: 1114556099
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALBRIGHT
FirstName: JOSEPH
MiddleName: HENRY
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1805 HOLLOWOOD DR
Address2:  
City: WINFIELD
State: KS
PostalCode: 671566300
CountryCode: US
TelephoneNumber: 6202224772
FaxNumber:  
Practice Location
Address1: 4401 WORNALL RD
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641113241
CountryCode: US
TelephoneNumber: 8169322000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/03/2020
LastUpdateDate: 04/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/03/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367H00000X  Y Physician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant 

No ID Information.


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