Basic Information
| Provider Information | |||||||||
| NPI: | 1326129891 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOSLYN | ||||||||
| FirstName: | ELAINE | ||||||||
| MiddleName: | WELSH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4601 INDEPENDENCE AVE | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641242927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162416334 | ||||||||
| FaxNumber: | 8162415830 | ||||||||
| Practice Location | |||||||||
| Address1: | 4601 INDEPENDENCE AVE | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641242927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162416334 | ||||||||
| FaxNumber: | 8162415830 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2006 | ||||||||
| LastUpdateDate: | 06/26/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | R2F46 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 11785054 | 01 | MO | BCBS OF KC | OTHER | 000015568 | 01 | MO | PTAN | OTHER | 242184612 | 05 | MO | MEDICAID |