Basic Information
| Provider Information | |||||||||
| NPI: | 1639595846 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OLATHE HEALTH PHYSICIANS, INC. | ||||||||
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| OtherOrganizationName: | OLATHE MEDICAL CENTER CANCER CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20333 W 151ST ST | ||||||||
| Address2: | |||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660615350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137914461 | ||||||||
| FaxNumber: | 9133248656 | ||||||||
| Practice Location | |||||||||
| Address1: | 20375 W 151ST ST | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660615306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137804000 | ||||||||
| FaxNumber: | 9137804038 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2014 | ||||||||
| LastUpdateDate: | 04/03/2018 | ||||||||
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| AuthorizedOfficialLastName: | WIENS | ||||||||
| AuthorizedOfficialFirstName: | CATHERINE | ||||||||
| AuthorizedOfficialMiddleName: | R. | ||||||||
| AuthorizedOfficialTitleorPosition: | VP/QUALITY AND COMPLIANCE | ||||||||
| AuthorizedOfficialTelephone: | 9137914459 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | OLATHE HEALTH PHYSICIANS, INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 207RX0202X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No ID Information.