Healthcare Provider Details

I. General information

NPI: 1316373897
Provider Name (Legal Business Name): MEDIQUICK CLINICS OF KANSAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16139 FOSTER ST
OVERLAND PARK KS
66085-8417
US

IV. Provider business mailing address

7111 W 151ST ST NUMBER 41
OVERLAND PARK KS
66223-2231
US

V. Phone/Fax

Practice location:
  • Phone: 913-413-0016
  • Fax: 913-413-0017
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number04-26778
License Number StateKS

VIII. Authorized Official

Name: DR. THEODORE J FELTS
Title or Position: OWNER
Credential: M.D.
Phone: 913-413-0016