Provider Demographics
NPI:1619191442
Name:POLICARD, JEAN-DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:JEAN-DANIEL
Middle Name:
Last Name:POLICARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W. 7TH. STREET , SUITE 100-A
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762
Mailing Address - Country:US
Mailing Address - Phone:620-231-7600
Mailing Address - Fax:620-231-7602
Practice Address - Street 1:200 E. CENTENNIAL DRIVE, SUITE 13
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762
Practice Address - Country:US
Practice Address - Phone:620-231-1068
Practice Address - Fax:620-231-2792
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS08-002492084P0800X
KS08002492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry