Provider Demographics
NPI:1083065510
Name:ROSEMARIE A ROMAIN-TYSON LLC
Entity Type:Organization
Organization Name:ROSEMARIE A ROMAIN-TYSON LLC
Other - Org Name:ROSEMARIE A ROMAIN-TYSON SOLE MBR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROMAIN-TYSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-381-7500
Mailing Address - Street 1:PO BOX 25571
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66225-5571
Mailing Address - Country:US
Mailing Address - Phone:913-381-7500
Mailing Address - Fax:913-381-7505
Practice Address - Street 1:4121 W 83RD ST
Practice Address - Street 2:254
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-5300
Practice Address - Country:US
Practice Address - Phone:913-381-7500
Practice Address - Fax:913-381-7505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty