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General NPI Number Information
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NPI Number | 1952731846
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Entity Type | Organization
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Legal Business Name | EYE ASSOCIATES OF SOUTH OLATHE
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Dates
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Enumeration Date | 11/14/2013
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Last Update Date | 05/15/2014
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Provider Practice Location Address
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Address Line | 16021 S BRADLEY DR
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City | OLATHE
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State | KS
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Zip | 66062-3932
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Country | US
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Telephone | 913-339-9090
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Fax |
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Provider Business Mailing Address
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Address Line | 16021 S BRADLEY DR
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City | OLATHE
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State | KS
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Zip | 66062-3932
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | INSURANCE COORDINATOR
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Name | AMY SHERIDAN
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Credential |
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Telephone | 913-339-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | KS1227
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License Number State | KS
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