Provider Demographics
NPI:1922012574
Name:SWEENEY, THOMAS P (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:SWEENEY
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 1:4801 W 110TH ST
Mailing Address - Street 2:STE 100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1347
Mailing Address - Country:US
Mailing Address - Phone:816-276-3493
Mailing Address - Fax:913-491-0411
Practice Address - Street 1:4801 W 100TH ST
Practice Address - Street 2:STE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211
Practice Address - Country:US
Practice Address - Phone:816-276-3493
Practice Address - Fax:913-491-0411
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1153232085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200595130Medicaid
MOP00057133OtherRAILROAD MEDICARE
MOP00057795OtherRAILROAD MEDICARE
KS100643740AMedicaid
MO1528169752OtherSECOND NPI NUMBER FOR MEDICARE GROUP # I23000A
MOP00057795OtherRAILROAD MEDICARE
MOP00057133OtherRAILROAD MEDICARE