Basic Information
| Provider Information | |||||||||
| NPI: | 1396061966 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOWSLEY | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | SHADE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8000 W 110TH ST | ||||||||
| Address2: | STE 150 | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662102382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135996777 | ||||||||
| FaxNumber: | 9135993955 | ||||||||
| Practice Location | |||||||||
| Address1: | 2411 HOLMES ST | ||||||||
| Address2: | UMKC SCHOOL OF MEDICINE RESIDENCY PROGRAM M2-302 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641082741 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169322107 | ||||||||
| FaxNumber: | 8169326104 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2010 | ||||||||
| LastUpdateDate: | 07/07/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.