Healthcare Provider Details

I. General information

NPI: 1194801621
Provider Name (Legal Business Name): AFTER-HOURS PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14300 METCALF AVE SUITE 122
OVERLAND PARK KS
66223-2987
US

IV. Provider business mailing address

14300 METCALF AVE SUITE 122
OVERLAND PARK KS
66223-2987
US

V. Phone/Fax

Practice location:
  • Phone: 913-825-4700
  • Fax: 913-825-4701
Mailing address:
  • Phone: 913-825-4700
  • Fax: 913-825-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CINDY B DAUGHERTY
Title or Position: CO-OWNER
Credential: MD
Phone: 913-825-4700