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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023214129 NPPES
Kansas MEDICAID 200743370A
Kansas Other P00991358
Kansas MEDICAID 1023214129

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