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10100 W 119th St Ste 150 Overland Park KS 66213-1604 | |
| (913) 754-0061 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 10100 W 119th St, Overland Park, Kansas |
| Authorized Official Name and Position | Chuck Chambers (ADMINISTRATOR) |
| Authorized Official Contact | 9134690503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 741331 Atlanta GA 30374-1331 Ph: (913) 428-1500 | 10100 W 119th St Ste 150 Overland Park KS 66213-1604 Ph: (913) 754-0061 |
| NPI Number | 1518122910 |
|---|---|
| Provider Enumeration Date | 07/24/2008 |
| Last Update Date | 12/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518122910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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