Provider Demographics
NPI:1194827410
Name:HERMRECK, ARLO S (MD)
Entity Type:Individual
Prefix:DR
First Name:ARLO
Middle Name:S
Last Name:HERMRECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD.
Mailing Address - Street 2:4070 DELP MAIL STOP 4017
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-7232
Mailing Address - Fax:913-588-7540
Practice Address - Street 1:3901 RAINBOW BLVD.
Practice Address - Street 2:DEPT. OF SURGERY, MAIL STOP 1037
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-7232
Practice Address - Fax:913-588-7540
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-13530208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS626030OtherFIRSTGUARD
MO04611066OtherBCBS KANSAS CITY
C50655Medicare UPIN
0090761AMedicare ID - Type Unspecified