Organization
LIFEMD KANSAS PATIENT MEDICAL CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATRINA A MARSHALL (DIR PE, CREDENTIALING AND LICENSING)
(919) 648-1113
Entity
Organization
Contact information
Practice address
7300 W 110TH ST STE 700, OVERLAND PARK, KS 66210-2332
(800) 852-1575
Mailing address
236 5TH AVE STE 400, NEW YORK, NY 10001-7606
(800) 852-1575
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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