Provider Demographics
NPI:1750584793
Name:CHENOWETH, JOHN RICHARD (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:RICHARD
Last Name:CHENOWETH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 S STRATFORD RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-2116
Mailing Address - Country:US
Mailing Address - Phone:913-764-2733
Mailing Address - Fax:
Practice Address - Street 1:1003 S STRATFORD RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-2116
Practice Address - Country:US
Practice Address - Phone:913-764-2733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05 14772207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C51908Medicare UPIN