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General NPI Number Information
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NPI Number | 1497357396
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Entity Type | Organization
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Legal Business Name | CARBON HEALTH MEDICAL GROUP OF KANSAS PA
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Dates
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Enumeration Date | 11/15/2020
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 8600 WARD PKWY STE 1019
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City | KANSAS CITY
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State | MO
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Zip | 64114-2614
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Country | US
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Telephone | 417-822-5933
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Fax |
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Provider Business Mailing Address
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Address Line | 10800 SAND HOLLOW CT
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City | RENO
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State | NV
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Zip | 89521-6294
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Country | US
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Telephone | 775-813-4777
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARLEY PAGE
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Credential |
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Telephone | 417-861-9739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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