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Grady Balthazor

NPI 1144125485 · on the registry since 2026 · sole proprietor

Practice

Address
17210 Midland Dr
Shawnee, KS 66217
Phone
(913) 777-9718
Clinicians at this address
123

Registry record

Primary taxonomy
106S00000X
106S00000X
Licence states on file
NULL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-10-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kansas