Provider Demographics
NPI:1023117579
Name:MIDWEST CARDIOVASCULAR AND THORACIC SURGEONS OF KANSAS, LLC
Entity type:Organization
Organization Name:MIDWEST CARDIOVASCULAR AND THORACIC SURGEONS OF KANSAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:KUENY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-373-7600
Mailing Address - Street 1:5701 W 119TH ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3722
Mailing Address - Country:US
Mailing Address - Phone:816-523-7088
Mailing Address - Fax:913-906-0829
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 120
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3722
Practice Address - Country:US
Practice Address - Phone:816-523-7088
Practice Address - Fax:913-906-0829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200462590GMedicaid
MO504046400Medicaid
KS200462590AMedicaid
KS200462590FMedicaid
MOMA1206Medicare PIN
MO504046400Medicaid