Provider Demographics
NPI:1245453661
Name:PANEK, JUDY LUCENA (MD)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:LUCENA
Last Name:PANEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:
Other - Last Name:KOMJATHY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:17630 S BLUEJACKET ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-9487
Mailing Address - Country:US
Mailing Address - Phone:913-897-2575
Mailing Address - Fax:
Practice Address - Street 1:16300 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1376
Practice Address - Country:US
Practice Address - Phone:913-410-2906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0424584207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine