Provider Demographics
NPI:1497061030
Name:FAMILY HEALTH MEDICAL GROUP OF OVERLAND PARK, LLC
Entity Type:Organization
Organization Name:FAMILY HEALTH MEDICAL GROUP OF OVERLAND PARK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:KUENY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-701-4090
Mailing Address - Street 1:12330 METCALF AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1324
Mailing Address - Country:US
Mailing Address - Phone:913-491-1616
Mailing Address - Fax:913-491-8061
Practice Address - Street 1:12330 METCALF AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1324
Practice Address - Country:US
Practice Address - Phone:913-491-1616
Practice Address - Fax:913-491-8061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty