Provider Demographics
NPI:1952339053
Name:MENNINGER, BRENT OHSE (MD)
Entity Type:Individual
Prefix:MR
First Name:BRENT
Middle Name:OHSE
Last Name:MENNINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8400 W 110TH ST
Mailing Address - Street 2:STE. 250
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2331
Mailing Address - Country:US
Mailing Address - Phone:913-327-7505
Mailing Address - Fax:913-327-7054
Practice Address - Street 1:8400 W 110TH ST
Practice Address - Street 2:STE. 250
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210
Practice Address - Country:US
Practice Address - Phone:913-327-7505
Practice Address - Fax:913-327-7054
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04233962084P0800X
KS04-233962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO35388014OtherBCBS GROUP NUMBER
MO27023037OtherBLUE CROSS BLUE SHIELD
KS66211A002OtherTRICARE
MO27023037OtherBLUE CROSS BLUE SHIELD
KSE55329Medicare UPIN