Johnson County Neurology Llc | |
5701 W 119th St Suite 102 Overland Park KS 66209-3722 | |
(913) 661-9434 | |
(913) 661-4688 |
Full Name | Johnson County Neurology Llc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 5701 W 119th St, Overland Park, Kansas |
Authorized Official Name and Position | Patrick J. Kueny (VP) |
Authorized Official Contact | 8165084090 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Johnson County Neurology Llc 12140 Nall Suite 230 Overland Park KS 66209-2503 Ph: (913) 661-9434 | Johnson County Neurology Llc 5701 W 119th St Suite 102 Overland Park KS 66209-3722 Ph: (913) 661-9434 |
NPI Number | 1194850115 |
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Provider Enumeration Date | 02/22/2007 |
Last Update Date | 07/28/2009 |
Medicare PECOS PAC ID | 8224134226 |
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Medicare Enrollment ID | O20070508000664 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194850115 | NPI | - | NPPES |
507292209 | Medicaid | MO | |
200428250A | Medicaid | KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
Provider Name | Stacy D Younger |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1043212210 PECOS PAC ID: 4082634993 Enrollment ID: I20051206000683 |
Provider Name | Robert Walter Jensen |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1083741961 PECOS PAC ID: 8224012737 Enrollment ID: I20120128000020 |
Provider Name | David F Clark |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1629230479 PECOS PAC ID: 8628218435 Enrollment ID: I20130722000423 |
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