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Contact Information

J DOUGLAS CUSICK, MD
4601 COLLEGE BLVD
SUITE 222
LEAWOOD, KS66211
 Phone: 913-661-0202
 Fax: 913-661-0584
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for J DOUGLAS CUSICK · (Male)

NPI # 1013027374
Status Active
Credentials MD
Entity Individual
Enumeration date 08/30/2006
Last updated 07/15/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • KS License # 0423923
  • MO License # MD100181
  • KS Medicaid 100458460A
  • MO Other 21177020 BLUE SHIELD IND #
Hospital affiliation(s)
  • SHAWNEE MISSION MEDICAL CENTER - (Acute Care)
    9100 W 74TH STREET
    SHAWNEE MISSION, KS 66204
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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