Provider Demographics
NPI:1073082350
Name:GERIATRIC PRIMARY CARE PA
Entity Type:Organization
Organization Name:GERIATRIC PRIMARY CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTIST
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:913-322-8859
Mailing Address - Street 1:PO BOX 14368
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66285-4368
Mailing Address - Country:US
Mailing Address - Phone:913-322-8859
Mailing Address - Fax:888-778-9471
Practice Address - Street 1:12500 W 137TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221-4129
Practice Address - Country:US
Practice Address - Phone:913-322-8859
Practice Address - Fax:888-778-9471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty