Provider Demographics
NPI:1750333670
Name:GREENWOOD, JOHN MILTON (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MILTON
Last Name:GREENWOOD
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 1:8708 W 135TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-2036
Mailing Address - Country:US
Mailing Address - Phone:913-851-9800
Mailing Address - Fax:913-851-9888
Practice Address - Street 1:8708 W 135TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221-2036
Practice Address - Country:US
Practice Address - Phone:913-851-9800
Practice Address - Fax:913-851-9888
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-23547207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100182560BMedicaid
KS0333073DMedicare PIN
F07764Medicare UPIN