Provider Demographics
NPI:1831860956
Name:KANSAS OCCUPATIONAL MEDICINE SERVICES
Entity type:Organization
Organization Name:KANSAS OCCUPATIONAL MEDICINE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-725-3043
Mailing Address - Street 1:PO BOX 1065
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-1065
Mailing Address - Country:US
Mailing Address - Phone:479-725-3046
Mailing Address - Fax:479-725-3098
Practice Address - Street 1:16801 W 116TH ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-9603
Practice Address - Country:US
Practice Address - Phone:913-538-0777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine