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Organization
KC PODIATRY CARE PA
Active
Organization
KC PODIATRY CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAPHAEL T NGUYEN DPM (PRESIDENT PODIATRIST)
(913) 432-2000
Entity
Organization
Contact information
Practice address
7301 MISSION RD, STE 152, PRAIRIE VILLAGE, KS 66208-3014
(913) 432-2000
Mailing address
7301 MISSION RD, STE 152, PRAIRIE VILLAGE, KS 66208-3014
(913) 432-2000
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
12-00309
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114130
MEDICARE PIN FOR KS NUMBE
KS
01
—
26580022
BCBS
KS
01
—
DC6711
RAILROAD PTAN
KS
01
—
P00183110
MEDICARE RAILROAD
KS
01
—
S340000
PTAN
KS
Enumeration date
07/18/2007
Last updated
05/24/2012
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