Provider Demographics
NPI:1689917940
Name:SHARP, JEREMY K (MD)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:K
Last Name:SHARP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:4440 BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3315
Mailing Address - Country:US
Mailing Address - Phone:816-531-0930
Mailing Address - Fax:816-531-2807
Practice Address - Street 1:17795 W 106TH ST STE 102
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061
Practice Address - Country:US
Practice Address - Phone:913-661-9990
Practice Address - Fax:913-273-1459
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
KS04-41244207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program