Basic Information
| Provider Information | |||||||||
| NPI: | 1740273465 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRATON | ||||||||
| FirstName: | KENNETH | ||||||||
| MiddleName: | STEVEN | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2330 SHAWNEE MISSION PKWY | ||||||||
| Address2: | MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312 | ||||||||
| City: | WESTWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662052005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9139455614 | ||||||||
| FaxNumber: | 9139455617 | ||||||||
| Practice Location | |||||||||
| Address1: | 12121 BLUE RIDGE EXT | ||||||||
| Address2: | STE. M | ||||||||
| City: | GRANDVIEW | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640306401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167610884 | ||||||||
| FaxNumber: | 8167611790 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2005 | ||||||||
| LastUpdateDate: | 12/06/2012 | ||||||||
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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 | 207Q00000X | R9426 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 481159444 | 01 | JHPC TAX ID | OTHER | P00324156 | 01 | RR MEDICARE# | OTHER | 18960020 | 01 | CFU BCBS | OTHER | 22039026 | 01 | BCBS PHF AFTER HOURS UC | OTHER | 37157012 | 01 | BCBS HIGHLAND MEDICAL | OTHER | 4001323 | 01 | AETNA | OTHER |