Provider Demographics
NPI:1740660604
Name:AMOS, JONATHAN VERNON (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:VERNON
Last Name:AMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5701 W 119TH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3749
Mailing Address - Country:US
Mailing Address - Phone:913-661-9980
Mailing Address - Fax:913-661-9173
Practice Address - Street 1:5701 W 119TH ST STE 209
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3749
Practice Address - Country:US
Practice Address - Phone:913-661-9980
Practice Address - Fax:913-661-9173
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KS04-43261207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program