Otis E Miller Ii, | |
9100 W 74th St, Shawnee Mission, KS 66204-4004 | |
(913) 676-2214 | |
Not Available |
Full Name | Otis E Miller Ii |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 9100 W 74th St, Shawnee Mission, Kansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1518968155 | NPI | - | NPPES |
26047069 | Other | MO | BCBS OF KC MO |
P00183119 | Other | RR MEDICARE GROUP DC6712 | |
01674018 | Other | BCBS KCMO GROUP 01674018 | |
26047049 | Other | KS | BCBS KC MO |
100345990C | Medicaid | KS | |
206039505 | Medicaid | MO | |
100345990A | Medicaid | KS | |
930128507 | Other | RR MEDICARE GROUP CC8899 |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 04-28117 (Kansas) | Primary |
Entity Name | Er Physicians South, P.a. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194100057 PECOS PAC ID: 2860458544 Enrollment ID: O20051101000964 |
Entity Name | Em Specialists Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801112743 PECOS PAC ID: 1153452644 Enrollment ID: O20100628000352 |
Entity Name | Kansas Medical Professionals Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629778766 PECOS PAC ID: 6800261181 Enrollment ID: O20230419001909 |
Mailing Address | Practice Location Address |
---|---|
Otis E Miller Ii, Po Box 411039, Kansas City, MO 64141-1039 Ph: (913) 234-1350 | Otis E Miller Ii, 9100 W 74th St, Shawnee Mission, KS 66204-4004 Ph: (913) 676-2214 |
Brett R Hailey, Emergency Medicine Medicare: Medicare Enrolled Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-676-2214 | |
Benjamin Thomas Sundling, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-676-2214 | |
Sean E Fulton, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-676-2214 | |
Dr. Kenneth A Newman, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-789-5561 Fax: 913-789-1835 | |
Darren Amundsen Boyack, Emergency Medicine Medicare: Medicare Enrolled Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-676-2214 Fax: 913-789-3106 | |
Ryan C Reeves, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-676-2214 |