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General NPI Number Information
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NPI Number | 1043493240
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Entity Type | Organization
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Legal Business Name | PITTSBURG EMERGENCY PHYSICIANS, LLC
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 1 MT CARMEL WAY
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City | PITTSBURG
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State | KS
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Zip | 66762-7587
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Country | US
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Telephone | 913-469-4244
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2785
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City | OVERLAND PARK
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State | KS
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Zip | 66201-2785
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Country | US
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Telephone | 913-469-4244
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Fax | 913-469-1939
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK S HOLCOMB
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Credential | MD
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Telephone | 913-469-4244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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