Provider Demographics
NPI:1205889169
Name:JAYHAWK HEALTHCARE LLC
Entity type:Organization
Organization Name:JAYHAWK HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GEIST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-838-1500
Mailing Address - Street 1:PO BOX 3727
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-0727
Mailing Address - Country:US
Mailing Address - Phone:785-838-1500
Mailing Address - Fax:
Practice Address - Street 1:3511 CLINTON PL
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-2196
Practice Address - Country:US
Practice Address - Phone:785-838-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
144044000OtherDEPT OF LABOR
KS22360023OtherBC/BS OF KC
KS110384OtherBC/BS OF KS
KS110384OtherBC/BS OF KS
KS22360023OtherBC/BS OF KC
CN6427Medicare PIN