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Contact Information

ADULT AND PEDIATRIC DERMATOLOGY
4601 W 109TH ST STE 116
OVERLAND PARK, KS66211-1313
 Phone: 913-469-1115
 Fax: 913-469-9192
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for ADULT AND PEDIATRIC DERMATOLOGY

NPI # 1609966753
LBN Legal business name ADULT AND PEDIATRIC DERMATOLOGY
Authorized official JENEAN KEMP - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/12/2006
Last updated 07/13/2022 - About 4 years ago
Identifiers
KS License # 0422209
KS Other CI3423 MEDICARE RAILROAD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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