Provider Demographics
NPI:1033311162
Name:JAYHAWK HEALTHCARE LLC
Entity Type:Organization
Organization Name:JAYHAWK HEALTHCARE LLC
Other - Org Name:LAWRENCE OCCUPATIONAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GEIST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-331-3783
Mailing Address - Street 1:PO BOX 3727
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-0727
Mailing Address - Country:US
Mailing Address - Phone:877-906-0924
Mailing Address - Fax:405-948-6507
Practice Address - Street 1:3511 CLINTON PL
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-2196
Practice Address - Country:US
Practice Address - Phone:785-331-3783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS117007OtherBC/BS OF KANSAS
KS22360013OtherBC/BS OF KANSAS CITY
110384Medicare PIN