Provider Demographics
NPI:1942319447
Name:INTERNAL MEDICINE SPECIALISTS, INC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-385-0176
Mailing Address - Street 1:10540 BARKLEY ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1811
Mailing Address - Country:US
Mailing Address - Phone:913-385-0176
Mailing Address - Fax:913-385-0782
Practice Address - Street 1:10540 BARKLEY ST
Practice Address - Street 2:SUITE 205
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1811
Practice Address - Country:US
Practice Address - Phone:913-385-0176
Practice Address - Fax:913-385-0782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO508639606Medicaid
MO08508051OtherBLUE CROSS BLUE SHIELD KC
KS100292510BMedicaid
KS74960OtherBLUE CROSS BLUE SHIELD KS
135645OtherCOVENTRY
4771317OtherAETNA
MO1540000Medicare ID - Type Unspecified
4771317OtherAETNA
KS1540000AMedicare ID - Type Unspecified