MEDICARE: JENNIFER LEIGH HARTWELL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	01076020A	IN
2	2086S0102X	Surgical Critical Care Physician	01076020A	IN
3	2086S0127X	Trauma Surgery Physician	036.121342	IL
4	2086S0127X	Trauma Surgery Physician	04-45624	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306024260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LEIGH HARTWELL MD

Provider Business Mailing Address
First Line	:	4000 CAMBRIDGE ST # MS 2005
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 CAMBRIDGE ST # MS 2005
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-1239
Country	:	US
Telephone Number	:	913-588-1214
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2008
Last Update Date	:	01/20/2022

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Directions to “ JENNIFER LEIGH HARTWELL MD” Practice Location

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