Healthcare Provider Details

I. General information

NPI: 1013901404
Provider Name (Legal Business Name): MIDWEST HOSPITAL SPECIALISTS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 10/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10901 GRANADA LN STE. 200
OVERLAND PARK KS
66211-1401
US

IV. Provider business mailing address

10901 GRANADA LN STE. 200
OVERLAND PARK KS
66211-1401
US

V. Phone/Fax

Practice location:
  • Phone: 913-660-1616
  • Fax: 913-660-1664
Mailing address:
  • Phone: 913-660-1616
  • Fax: 913-660-1664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS H SIMMONS
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 913-660-1616