Basic Information
| Provider Information | |||||||||
| NPI: | 1629460167 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MID-AMERICA ORTHOPEDICS KC LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4940 W. 137TH ST. | ||||||||
| Address2: | |||||||||
| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9132329846 | ||||||||
| FaxNumber: | 9132329817 | ||||||||
| Practice Location | |||||||||
| Address1: | 4940 W. 137TH ST. | ||||||||
| Address2: | |||||||||
| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662243723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9132329846 | ||||||||
| FaxNumber: | 3169789001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2015 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | DO | ||||||||
| AuthorizedOfficialFirstName: | PAT | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD/CEO | ||||||||
| AuthorizedOfficialTelephone: | 3162624886 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.