Provider Demographics
NPI:1649459751
Name:JAYHAWK PRIMARY CARE INC
Entity type:Organization
Organization Name:JAYHAWK PRIMARY CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-945-5603
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-945-5614
Mailing Address - Fax:
Practice Address - Street 1:2330 SHAWNEE MISSION PKWY
Practice Address - Street 2:WESTWOOD URGENT CARE STE. 2201
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-2005
Practice Address - Country:US
Practice Address - Phone:913-588-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAYHAWK PRIMARY CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-25
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
39415017OtherBCBS GROUP NUMBER
39415017OtherBCBS GROUP NUMBER
KSJ610000AMedicare PIN