Basic Information
| Provider Information | |||||||||
| NPI: | 1376523563 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALLAN | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2330 SHAWNEE MISSION PARKWAY | ||||||||
| Address2: | MEDICAL ADMINISTRATIVE SERVICES OF KU STE. 312 | ||||||||
| City: | WESTWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662050000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9139455614 | ||||||||
| FaxNumber: | 9139455617 | ||||||||
| Practice Location | |||||||||
| Address1: | 10787 NALL AVE | ||||||||
| Address2: | STE. 310 | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662111375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9139456900 | ||||||||
| FaxNumber: | 9139456970 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2006 | ||||||||
| LastUpdateDate: | 09/16/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | R3509 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 04-14838 | KS | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | AL202908109 | 05 | MO | MEDICAID |