Provider Demographics
NPI:1992890339
Name:CARLISLE, JOHN C (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:CARLISLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3651 COLLEGE BLVD STE 100A
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1910
Mailing Address - Country:US
Mailing Address - Phone:913-319-7600
Mailing Address - Fax:913-253-1702
Practice Address - Street 1:3651 COLLEGE BLVD STE 100A
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1910
Practice Address - Country:US
Practice Address - Phone:913-319-7600
Practice Address - Fax:913-253-1702
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010015929207X00000X
KS04-34445207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P01080854OtherRAILROAD MEDICARE
KSKA2451006Medicare PIN
P01080854OtherRAILROAD MEDICARE