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Contact Information

KENNETH R WATSON, DO
10330 HICKMAN MILLS DR
KANSAS CITY, MO64137-1618
 Phone: 816-412-7004
 Fax: 816-763-7536
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for KENNETH R WATSON · (Male)

NPI Number 1114905221
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 01/09/2006
Last updated 11/26/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 20A9489
  • MO License # R8692
  • KS Medicaid 100229790A
  • KS Medicaid 241950005
Hospital affiliation(s)
  • SHAWNEE MISSION MEDICAL CENTER - (Acute Care)
    9100 W 74TH STREET
    SHAWNEE MISSION, KS 66204
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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