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Organization
PARK PLACE SURGERY CENTER, INC.
Active
Organization
PARK PLACE SURGERY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN L BAEKE M.D. (MEDICAL DIRECTOR)
(913) 685-0101
Entity
Organization
Contact information
Practice address
14950 NEWTON DR, OVERLAND PARK, KS 66223-2212
(913) 685-0101
(913) 685-3666
Mailing address
14950 NEWTON DR, OVERLAND PARK, KS 66223-2212
(913) 685-0101
(913) 685-3666
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
S046020
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
91145013
BLUE CROSS BLUE SHIELD KC
KS
Enumeration date
07/01/2005
Last updated
08/22/2020
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