Provider Demographics
NPI:1841294535
Name:MCGOVNEY, JANICE K (MD)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:K
Last Name:MCGOVNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 CLAY EDWARDS DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3251
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:816-346-7690
Practice Address - Street 1:6080 N OAK TRFY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-5158
Practice Address - Country:US
Practice Address - Phone:164-539-2328
Practice Address - Fax:816-455-2423
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8A47207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201313830Medicaid
MOMA5696002Medicare PIN
MO201313830Medicaid