Basic Information
Provider Information
NPI: 1265656979
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OBERHELMAN
FirstName: AMY
MiddleName: PATRICIA
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5800 FOXRIDGE DR
Address2: STE 240
City: MISSION
State: KS
PostalCode: 662022347
CountryCode: US
TelephoneNumber: 9133625434
FaxNumber:  
Practice Location
Address1: 20333 W 151ST ST
Address2:  
City: OLATHE
State: KS
PostalCode: 660615350
CountryCode: US
TelephoneNumber: 9137914291
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/12/2007
LastUpdateDate: 08/01/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X42988KYN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X2003013842MON Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X04-36265KSY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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