Ford, Deetra Yelena
Ford, Deetra Yelena is an sole proprietor health care provider with primary practice located at 3901 Rainbow Blvd , Kansas City KS 66160-8500. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Ford, Deetra Yelena can be contacted via phone (913) 945-8700.Contact Information
Primary practice address
3901 Rainbow Blvd
Kansas City KS 66160-8500
Phone: (913) 945-8700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 946742 | Kansas |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 2011021426 | Missouri |
Profile Details
| NPI number | 1023214129 |
|---|---|
| LBN Legal business name | Ford, Deetra Yelena |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 25th, 2007 |
| Last updated | Jul 25th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023214129 | NPPES |
| Kansas | MEDICAID | 200743370A | |
| Kansas | Other | P00991358 | |
| Kansas | MEDICAID | 1023214129 |
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