Basic Information
| Provider Information | |||||||||
| NPI: | 1831202704 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOSKEY | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7800 COLLEGE BLVD. | ||||||||
| Address2: | STE. 200 | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662101870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9134913999 | ||||||||
| FaxNumber: | 9133872000 | ||||||||
| Practice Location | |||||||||
| Address1: | 8101 W 135TH ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662231111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9134913999 | ||||||||
| FaxNumber: | 9134919309 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2006 | ||||||||
| LastUpdateDate: | 03/05/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 2000146088 | MO | N | Allopathic & Osteopathic Physicians | Anesthesiology | 208VP0000X | 0430480 | KS | Y | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1831202704 | 05 | MO | MEDICAID |