Provider Demographics
NPI:1023210556
Name:GEORGE S DEVINS
Entity Type:Organization
Organization Name:GEORGE S DEVINS
Other - Org Name:DEVINS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:S
Authorized Official - Last Name:DEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-363-0787
Mailing Address - Street 1:6724 TROOST AVE
Mailing Address - Street 2:STE 304
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1500
Mailing Address - Country:US
Mailing Address - Phone:816-363-0787
Mailing Address - Fax:816-363-5090
Practice Address - Street 1:6724 TROOST AVE
Practice Address - Street 2:STE 304
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1500
Practice Address - Country:US
Practice Address - Phone:816-363-0787
Practice Address - Fax:816-363-5090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO28935207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO49-7389501OtherTAX ID#
MOA970470AOtherMEDICARE PROVIDER NUMBER
KSA970470COtherMEDICARE PROVIDER NUMBER
KS1023084969OtherNPI NUMBER
MO110037923OtherRAILROAD MEDICARE
KS$$$$$$$$$OtherSSN
MO1023210556OtherNPI GROUP
KS1568655108OtherNPI GROUP NUMBER
MO200173920OtherMEDICAID GROUP NUMBER
MO507676013OtherMEDICAID GROUP
MO1023084969OtherNPI NUMBER
KS110038097OtherRAILROAD MEDICARE NUMBER
KS507676005Medicaid
MO200173920OtherMEDICAID GROUP NUMBER
KS110038097OtherRAILROAD MEDICARE NUMBER
MOC50007Medicare UPIN
KSDH1271Medicare PIN