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General NPI Number Information
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NPI Number | 1689772949
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Entity Type | Organization
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Legal Business Name | SELECT HEALTHCARE PA
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 12140 NALL AVE STE 305
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City | OVERLAND PARK
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State | KS
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Zip | 66209-2501
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Country | US
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Telephone | 913-948-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 12140 NALL AVE STE 305
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City | OVERLAND PARK
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State | KS
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Zip | 66209-2501
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Country | US
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Telephone | 913-948-6400
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Fax | 913-438-2128
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | PEGGY G DAVIS
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Credential |
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Telephone | 913-948-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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