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Organization
WESTPORT ANESTHESIA SERVICES OF KANSAS PA
Active
Organization
WESTPORT ANESTHESIA SERVICES OF KANSAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH DYER (COO)
(816) 389-6030
Entity
Organization
Contact information
Practice address
12300 METCALF AVE, ANESTHESIA DEPT, OVERLAND PARK, KS 66213-1324
(816) 389-6030
(816) 389-6034
Mailing address
9233 WARD PKWY, SUITE 230, KANSAS CITY, MO 64114-3366
(816) 389-6030
(816) 389-6034
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049966
KS FHP GROUP NUMBER
KS
01
—
26436019
BCBS GROUP NUMBER
KS
01
—
405260
BCBS-KS GROUP NUMBER
KS
01
—
CG1847
RR MEDICARE GROUP NUMBER
KS
Enumeration date
05/17/2006
Last updated
02/12/2008
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