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General NPI Number Information
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NPI Number | 1134920580
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Entity Type | Organization
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Legal Business Name | MIDWEST PHYSICIAN GROUP, LLC
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 8655 COLLEGE BLVD
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City | OVERLAND PARK
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State | KS
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Zip | 66210-1835
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Country | US
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Telephone | 913-648-0073
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Fax |
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Provider Business Mailing Address
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Address Line | 8655 COLLEGE BLVD
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City | OVERLAND PARK
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State | KS
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Zip | 66210-1835
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | TERESA STARKS
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Credential |
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Telephone | 913-544-3122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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