Healthcare Provider Details

I. General information

NPI: 1174562052
Provider Name (Legal Business Name): KS URGENT CARE CENTER OF KANSAS CITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 10/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 MEADOWLARK LN SUITE D
KANSAS CITY KS
66102-1266
US

IV. Provider business mailing address

1601 MEADOWLARK LN SUITE D
KANSAS CITY KS
66102-1266
US

V. Phone/Fax

Practice location:
  • Phone: 913-287-1400
  • Fax: 913-287-1402
Mailing address:
  • Phone: 913-287-1400
  • Fax: 913-287-1402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number04-13380
License Number StateKS

VIII. Authorized Official

Name: DR. ALAN C HANCOCK
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 913-287-1400