Basic Information
| Provider Information | |||||||||
| NPI: | 1932273737 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KANSAS CITY NEUROLOGY ASSOCIATES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 SE BLUE PKWY | ||||||||
| Address2: | SUITE 270-A | ||||||||
| City: | LEES SUMMIT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640631018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165241700 | ||||||||
| FaxNumber: | 8165241794 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 SE BLUE PKWY | ||||||||
| Address2: | SUITE 270-A | ||||||||
| City: | LEES SUMMIT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640631018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165241700 | ||||||||
| FaxNumber: | 8165241794 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2006 | ||||||||
| LastUpdateDate: | 12/30/2009 | ||||||||
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| AuthorizedOfficialLastName: | KUENY | ||||||||
| AuthorizedOfficialFirstName: | PATRICK | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8165084090 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 502570609 | 05 | MO | MEDICAID | 1932273737 | 05 | MO | MEDICAID | 200532770 A | 05 | KS | MEDICAID |