MEDICARE: MR. JOHN S. DYKSTRA X DO

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	2085R0202X	Diagnostic Radiology Physician	R4721	MO
2	2085R0202X	Diagnostic Radiology Physician	0516561	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	2239077	OTHER	MO	AETNA
3	03870079	OTHER	MO	BCBS
4	067407	OTHER	KS	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720061690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN S. DYKSTRA X DO

Provider Business Mailing Address
First Line	:	PO BOX 414975
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64141-4975
Country	:	US
Telephone Number	:	816-455-0661
Fax Number	:	816-454-1080

Provider Business Practice Location Address
First Line	:	9501 N OAK TRFY
Second Line	:	SUITE 100
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2256
Country	:	US
Telephone Number	:	816-455-0661
Fax Number	:	816-454-1080

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

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	09/28/2010

Similar Medicare Providers

1912980194 — SOCRATES C. JAMOULIS MD
Practice Location Address:

9501 N OAK TRFY , #100
KANSAS CITY, MO
64155-2256

Practice Phone: 816-455-0661
Practice Fax: 816-454-1080

1245213420 — GERALD E. FINKE MD
Practice Location Address:

9501 N OAK TRFY
KANSAS CITY, MO
64155-2256

Practice Phone: 816-455-0661
Practice Fax: 816-454-1080

1477533503 — CHARLES F SCHWAB D.O.
Practice Location Address:

9501 N OAK TRFY , #100
KANSAS CITY, MO
64155-2256

Practice Phone: 816-455-0661
Practice Fax: 816-455-3905

1811977952 — JOSEPH W. WITHAM MD
Practice Location Address:

9501 N OAK TRFY , #100
KANSAS CITY, MO
64155-2256

Practice Phone: 816-455-0661
Practice Fax: 816-454-1080

1558314492 — TOTAL HEALTH PSYCHOLOGY PC
Practice Location Address:

9501 N OAK TRFY , SUITE 201
KANSAS CITY, MO
64155-2256

Practice Phone: 816-420-9292
Practice Fax: 816-420-9696

1952358624 — JOHN F THROCKMORTON III PT
Practice Location Address:

9501 N OAK TRFY , SUITE 201
KANSAS CITY, MO
64155-2256

Practice Phone: 816-468-5278
Practice Fax: 816-285-5278

Directions to “ MR. JOHN S. DYKSTRA X DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.