Healthcare Provider Details

I. General information

NPI: 1639595846
Provider Name (Legal Business Name): OLATHE HEALTH PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2014
Last Update Date: 04/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20375 W 151ST ST SUITE 208
OLATHE KS
66061-5306
US

IV. Provider business mailing address

20333 W 151ST ST
OLATHE KS
66061-5350
US

V. Phone/Fax

Practice location:
  • Phone: 913-780-4000
  • Fax: 913-780-4038
Mailing address:
  • Phone: 913-791-4461
  • Fax: 913-324-8656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE R. WIENS
Title or Position: VP/QUALITY AND COMPLIANCE
Credential:
Phone: 913-791-4459