Organization
KANSAS CITY CANCER CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN E. HENNESSY (EXECUTIVE DIRECTOR)
(913) 541-4607
Entity
Organization
Contact information
Practice address
12200 W 110TH ST, OVERLAND PARK, KS 66210-4045
(913) 234-0400
(913) 234-0551
Mailing address
9200 INDIAN CREEK PKWY, BLDG. 9, STE. 300, OVERLAND PARK, KS 66210-2002
(913) 541-4600
(913) 541-4692
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RX0202X
Medical Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100343680A
—
KS
05
—
100343680C
—
KS
05
—
507285401
—
MO
01
—
CC9941
RAILROAD MEDICARE
MO
01
—
CC9942
RAILROAD MEDICARE
KS
Enumeration date
05/05/2006
Last updated
05/21/2008
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