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General NPI Number Information
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NPI Number | 1356308878
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Entity Type | Organization
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Legal Business Name | JAYHAWK PRIMARY CARE INC
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6515 N COSBY AVE PICTURE HILLS FAMILY MEDICINE
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City | KANSAS CITY
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State | MO
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Zip | 64151-2380
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Country | US
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Telephone | 816-505-5050
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Fax | 816-587-7708
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Provider Business Mailing Address
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Address Line | 2330 SHAWNEE MISSION PKWY MEDICAL ADMINISTRATIVE SERVICES OF KU MED. STE. 312
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City | WESTWOOD
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State | KS
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Zip | 66205-2005
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Country | US
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Telephone | 913-588-9000
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Fax | 913-588-9822
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Authorized Official
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Title or Position | HR DIRECTOR
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Name | PAMELA J. MYRTLE
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Credential |
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Telephone | 913-588-9808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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