Provider Demographics
NPI:1952734741
Name:MIDWEST PHYSICIAN SERVICES, LLC
Entity Type:Organization
Organization Name:MIDWEST PHYSICIAN SERVICES, LLC
Other - Org Name:MID AMERICA PHYSICIAN SERVICES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:913-266-8929
Mailing Address - Street 1:5525 W 119TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3724
Mailing Address - Country:US
Mailing Address - Phone:913-491-4020
Mailing Address - Fax:913-491-4725
Practice Address - Street 1:5525 W 119TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3724
Practice Address - Country:US
Practice Address - Phone:913-491-4020
Practice Address - Fax:913-491-4725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-15
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty