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720 Central Ave Kansas City KS 66101-3546 | |
| (913) 321-3343 | |
| (913) 321-3348 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 720 Central Ave, Kansas City, Kansas |
| Authorized Official Name and Position | Mark Pederson (MANAGER) |
| Authorized Official Contact | 9133213343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
720 Central Ave Kansas City KS 66101-3546 Ph: (913) 321-3343 | 720 Central Ave Kansas City KS 66101-3546 Ph: (913) 321-3343 |
| NPI Number | 1285831305 |
|---|---|
| Provider Enumeration Date | 07/02/2007 |
| Last Update Date | 11/29/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285831305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 04-13172 (Kansas) | Primary |
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