Healthcare Provider Details

I. General information

NPI: 1194717223
Provider Name (Legal Business Name): TERRY EUGENE LIENHOP DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TERRENCE EUGENE LIENHOP

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 W AUBERRY GRV
JAMESPORT MO
64648-7189
US

IV. Provider business mailing address

10975 BENSON DR SUITE 250
OVERLAND PARK KS
66210
US

V. Phone/Fax

Practice location:
  • Phone: 660-684-6252
  • Fax:
Mailing address:
  • Phone: 913-469-1488
  • Fax: 913-469-1441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2003021691
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2003021691
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: