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General NPI Number Information
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NPI Number | 1235460007
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Entity Type | Organization
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Legal Business Name | QUINN PLASTIC SURGERY CENTER PC
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 03/05/2010
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Provider Practice Location Address
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Address Line | 6920 W 121ST ST SUITE102
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City | OVERLAND PARK
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State | KS
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Zip | 66209-2006
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Country | US
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Telephone | 913-492-3443
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Fax | 913-492-1881
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Provider Business Mailing Address
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Address Line | 6920 W 121ST ST SUITE102
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City | OVERLAND PARK
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State | KS
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Zip | 66209-2006
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Country | US
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Telephone | 913-492-3443
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Fax | 913-492-1881
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN M QUINN
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Credential | M.D., F.A.C.S.
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Telephone | 913-492-3443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | R5C63
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 421809
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License Number State | KS
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