Provider Demographics
NPI:1811939929
Name:LEHMAN, SAMUEL R (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:R
Last Name:LEHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CARONDELET DR
Mailing Address - Street 2:PROVIDER ENROLLMENT/MED STAFF OFC
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114
Mailing Address - Country:US
Mailing Address - Phone:816-943-5744
Mailing Address - Fax:
Practice Address - Street 1:10550 QUIVIRA RD
Practice Address - Street 2:SUITE 530
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2306
Practice Address - Country:US
Practice Address - Phone:913-599-3828
Practice Address - Fax:913-599-3451
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20010124302084N0400X
KS04-239842084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100130410 FMedicaid
KS100130410 FMedicaid
KSP00653597Medicare PIN
KSY20000002Medicare PIN
KSP680166Medicare ID - Type Unspecified