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General NPI Number Information
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NPI Number | 1558356543
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Entity Type | Individual
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Provider Name | RANDY C LUZANIA MD
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Gender | Male
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 5701 W 119TH ST SUITE 135
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City | OVERLAND PARK
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State | KS
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Zip | 66209-3721
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Country | US
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Telephone | 913-451-1311
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Fax | 913-451-7511
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Provider Business Mailing Address
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Address Line | 5701 W 119TH ST SUITE 410
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City | OVERLAND PARK
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State | KS
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Zip | 66209-3721
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Country | US
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Telephone | 913-345-3650
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Fax | 913-345-3807
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MD 111595
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 04-26419
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License Number State | KS
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