Healthcare Provider Details

I. General information

NPI: 1811940877
Provider Name (Legal Business Name): JOHNSON COUNTY ANESTHESIOLOGISTS, CHARTERED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20375 W 151ST ST SUITE 306
OLATHE KS
66061-5306
US

IV. Provider business mailing address

PO BOX 75443
CHICAGO IL
60675-5443
US

V. Phone/Fax

Practice location:
  • Phone: 913-782-2292
  • Fax: 913-782-2381
Mailing address:
  • Phone: 717-263-5562
  • Fax: 717-263-1566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY MUNRO
Title or Position: PRESIDENT
Credential: MD
Phone: 913-685-8861