Provider Demographics
NPI:1649729443
Name:CHILDREN'S MERCY-JOHNSON COUNTY PEDIATRICS, INC
Entity type:Organization
Organization Name:CHILDREN'S MERCY-JOHNSON COUNTY PEDIATRICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:FINUF
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:816-559-9374
Mailing Address - Street 1:8800 W 75TH ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2205
Mailing Address - Country:US
Mailing Address - Phone:913-384-5500
Mailing Address - Fax:
Practice Address - Street 1:8800 W 75TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2205
Practice Address - Country:US
Practice Address - Phone:913-384-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty