Provider Demographics
NPI:1861454324
Name:OBOYNICK, PAUL LEONARD (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:LEONARD
Last Name:OBOYNICK
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 1:7450 KESSLER ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2553
Mailing Address - Country:US
Mailing Address - Phone:913-632-9480
Mailing Address - Fax:913-632-9499
Practice Address - Street 1:7450 KESSLER ST STE 202
Practice Address - Street 2:
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2553
Practice Address - Country:US
Practice Address - Phone:913-632-9480
Practice Address - Fax:913-632-9499
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0418151207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSC50667Medicare UPIN
KSQ034099Medicare ID - Type Unspecified