Provider Demographics
NPI:1033342647
Name:MID AMERICA SARCOMA INSTITUTE PA
Entity Type:Organization
Organization Name:MID AMERICA SARCOMA INSTITUTE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-498-6840
Mailing Address - Street 1:12140 NALL AVE
Mailing Address - Street 2:SUITE 200-A
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2507
Mailing Address - Country:US
Mailing Address - Phone:913-498-6840
Mailing Address - Fax:913-696-1434
Practice Address - Street 1:12140 NALL AVE.
Practice Address - Street 2:SUITE 200-A
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2507
Practice Address - Country:US
Practice Address - Phone:913-498-6840
Practice Address - Fax:913-696-1434
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MID-AMERICA SARCOMA INSTITUTE, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-29
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0421610207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100130000BMedicaid