MEDICARE: JONATHAN WARREN MD, FACS

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	94-08123	KS
2	208600000X	Surgery Physician	04-41101	KS

General Provider Information

NPI Number	:	1407198575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN WARREN MD, FACS

Provider Business Mailing Address
First Line	:	4409 FRANCIS ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66103-3532
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20375 W 151ST ST STE 463
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-7210
Country	:	US
Telephone Number	:	913-782-8577
Fax Number	:

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

Provider Enumeration Date	:	03/26/2013
Last Update Date	:	08/12/2024

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