# JAYHAWK PRIMARY CARE INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JAYHAWK PRIMARY CARE INC
- **Other names:** State Avenue Health Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1326383274
- **Legal business name:** JAYHAWK PRIMARY CARE INC
- **Authorized official:** MICHAEL OLSON (COO)
- **Authorized official phone:** (913) 945-9740

## Contact information

- **Practice address:** 4810 STATE AVE, STATE AVENUE HEALTH CARE, KANSAS CITY, KS 66102-1748
- **Practice address phone:** (913) 945-9740
- **Practice address fax:** (913) 945-9741
- **Mailing address:** 4810 STATE AVE, STATE AVENUE HEALTH CARE, KANSAS CITY, KS 66102-1748
- **Mailing address phone:** (913) 945-9740
- **Mailing address fax:** (913) 945-9741

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/04/2012
- **Last updated:** 12/04/2012