Provider Demographics
NPI:1003810896
Name:PRICE, RICHARD BROOKE (MD, PA)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:BROOKE
Last Name:PRICE
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12330 METCALF AVE STE 550
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1305
Mailing Address - Country:US
Mailing Address - Phone:913-491-3900
Mailing Address - Fax:913-491-5444
Practice Address - Street 1:5370 COLLEGE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1891
Practice Address - Country:US
Practice Address - Phone:913-599-4800
Practice Address - Fax:913-599-2992
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS23413174400000X, 207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC13787011OtherBCBS PROVIDER #
SC13787011OtherBCBS PROVIDER #
KS0006468BMedicare ID - Type Unspecified