Healthcare Provider Details

I. General information

NPI: 1114418431
Provider Name (Legal Business Name): LANCE M VILLENEUVE MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 QUIVIRA RD
OVERLAND PARK KS
66215-2306
US

IV. Provider business mailing address

10500 QUIVIRA RD
OVERLAND PARK KS
66215-2306
US

V. Phone/Fax

Practice location:
  • Phone: 931-541-5000
  • Fax:
Mailing address:
  • Phone: 931-541-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number036.174856
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: