Provider Demographics
NPI:1083772172
Name:GREGORY H. MEARS, DO
Entity Type:Organization
Organization Name:GREGORY H. MEARS, DO
Other - Org Name:MEARS MEDICAL ENTERPRISES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:HOLT
Authorized Official - Last Name:MEARS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:620-331-5440
Mailing Address - Street 1:200 ARCO PL
Mailing Address - Street 2:SUITE 333
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301-3398
Mailing Address - Country:US
Mailing Address - Phone:620-331-5440
Mailing Address - Fax:620-331-3791
Practice Address - Street 1:200 ARCO PL
Practice Address - Street 2:SUITE 333
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-3398
Practice Address - Country:US
Practice Address - Phone:620-331-5440
Practice Address - Fax:620-331-3791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-21870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110687Medicare ID - Type UnspecifiedGROUP #