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General NPI Number Information
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NPI Number | 1306133566
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Entity Type | Organization
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Legal Business Name | KANSAS CITY SPORTS MEDICINE INC
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 712 1ST TER
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City | LANSING
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State | KS
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Zip | 66043-1735
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Country | US
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Telephone | 913-351-3005
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Fax | 913-351-3009
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Provider Business Mailing Address
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Address Line | 712 1ST TER
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City | LANSING
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State | KS
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Zip | 66043-1735
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Country | US
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Telephone | 913-351-3005
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Fax | 913-351-3009
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Authorized Official
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Title or Position | OWNER
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Name | DR. PREM PARMAR
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Credential | M.D.
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Telephone | 913-351-3005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 04-28802
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License Number State | KS
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