Provider Demographics
NPI:1922059914
Name:BENE, RICHARD JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOHN
Last Name:BENE
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 135TH ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-8901
Mailing Address - Country:US
Mailing Address - Phone:913-663-3838
Mailing Address - Fax:913-663-4434
Practice Address - Street 1:4801 W 135TH ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224
Practice Address - Country:US
Practice Address - Phone:913-663-3838
Practice Address - Fax:913-663-4434
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-24860174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS103250OtherMEDICARE
MOG399673AOtherMEDICARE
KSF57744Medicare UPIN
MOG399673AOtherMEDICARE