Individual
DR. JONATHAN EDWARD FERNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 632-2230
(913) 632-2297
Mailing address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2679
(913) 789-3191
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0436488
KS
207L00000X
Anesthesiology Physician
2012028958
MO
208VP0000X
Pain Medicine Physician
0436488
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201074940A
—
KS
01
—
P01231496
RR MEDICARE
KS
Enumeration date
04/10/2008
Last updated
11/10/2020
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