MEDICARE: JAYHAWK PRIMARY CARE INC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1982845970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAYHAWK PRIMARY CARE INC

Provider Business Mailing Address
First Line	:	2330 SHAWNEE MISSION PKWY
Second Line	:	MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE.312
City	:	WESTWOOD
State	:	KS
Zip	:	66205-2005
Country	:	US
Telephone Number	:	913-945-5614
Fax Number	:	913-945-5617

Provider Business Practice Location Address
First Line	:	10787 NALL AVE
Second Line	:	STE. 310
City	:	OVERLAND PARK
State	:	KS
Zip	:	66211-0000
Country	:	US
Telephone Number	:	913-945-6900
Fax Number	:	913-945-6970

Authorized Official
Title or Position	:	DIRECTOR
Name	:	STEVEN BROWN
Credential	:
Telephone Number	:	913-945-5603

Provider Enumeration Date	:	03/20/2009
Last Update Date	:	05/29/2013

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