Provider Demographics
NPI:1841512167
Name:SPORTS MEDICINE CONSULTANTS
Entity type:Organization
Organization Name:SPORTS MEDICINE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:913-485-5248
Mailing Address - Street 1:5363 ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226-3938
Mailing Address - Country:US
Mailing Address - Phone:913-485-5248
Mailing Address - Fax:913-422-0061
Practice Address - Street 1:5363 ROBERTS ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66226-3938
Practice Address - Country:US
Practice Address - Phone:913-485-5248
Practice Address - Fax:913-422-0061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0527613207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty