Healthcare Provider Details

I. General information

NPI: 1417299207
Provider Name (Legal Business Name): JENNIFER THOMPSON EYLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 W 151ST ST
OLATHE KS
66061-5305
US

IV. Provider business mailing address

153 W 151ST ST STE 100
OLATHE KS
66061-5300
US

V. Phone/Fax

Practice location:
  • Phone: 913-764-1125
  • Fax: 913-764-1186
Mailing address:
  • Phone: 913-764-1125
  • Fax: 913-764-1186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number0439795
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number125.063136
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: