Provider Demographics
NPI:1831685353
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:SENIOR ADMINISTRATOR, JPC ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:JANELL
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-945-5592
Mailing Address - Street 1:1403 GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64106-2917
Mailing Address - Country:US
Mailing Address - Phone:816-268-4295
Mailing Address - Fax:816-268-4297
Practice Address - Street 1:1403 GRAND BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-2917
Practice Address - Country:US
Practice Address - Phone:816-268-4295
Practice Address - Fax:816-268-4297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty