Provider Demographics
NPI:1184622730
Name:MIDWEST EAR NOSE AND THROAT LLC
Entity type:Organization
Organization Name:MIDWEST EAR NOSE AND THROAT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:METZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-764-2737
Mailing Address - Street 1:PO BOX 874480
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64187-0001
Mailing Address - Country:US
Mailing Address - Phone:913-764-2737
Mailing Address - Fax:913-764-7502
Practice Address - Street 1:20375 W 151ST ST
Practice Address - Street 2:STE #106
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061
Practice Address - Country:US
Practice Address - Phone:913-764-2737
Practice Address - Fax:913-764-7502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110356OtherKS MEDICARE
14136024OtherBCBS - KC
702788OtherBCBS - KS
KSCE8450OtherMEDICARE RAILROAD
KSD44000OtherKC MEDICARE