Provider Demographics
NPI:1619314176
Name:HEARTLAND PHYSICIAN SERVICES, LLC
Entity Type:Organization
Organization Name:HEARTLAND PHYSICIAN SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CNO
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-956-2275
Mailing Address - Street 1:4801 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1628
Mailing Address - Country:US
Mailing Address - Phone:913-956-2250
Mailing Address - Fax:913-956-2251
Practice Address - Street 1:4801 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1628
Practice Address - Country:US
Practice Address - Phone:913-956-2250
Practice Address - Fax:913-956-2251
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTLAND SURGICAL SPECIALTY HOSPITAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-23
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity MedicineGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty