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Physicians Surgery

Provider NPI: 1275644114

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 913-588-7743  Fax: 913-588-9786

Business Mailing Address:
Tel: 913-588-9000  Fax: 913-588-9822

NPI Information:
NPI: 1275644114
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Thoracic Surgery (Cardiothoracic Vascular Surgery)

Other Provider Identifiers:

CHP PSKU1000126620201
BCBS PSKU1664504601

American Medical Association 2012 taxonomy code information

Code: 208G00000X





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