# COLLEGE PARK FAMILY CARE CENTER, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** College Park Radiology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881803229
- **Authorized official:** CHUCK CHAMBERS (ADMINISTRATOR)
- **Authorized official phone:** (913) 469-0503

## Contact information

- **Practice address:** 11755 W 112TH ST, STE. 101, OVERLAND PARK, KS 66210-2761
- **Practice address phone:** (913) 469-0503
- **Practice address fax:** (913) 338-1311
- **Mailing address:** 11755 W 112TH ST, STE. 101, OVERLAND PARK, KS 66210-2761
- **Mailing address phone:** (913) 469-0503
- **Mailing address fax:** (913) 338-1311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/22/2007
- **Last updated:** 08/10/2007