Individual
JEREMY LEE COWGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7450 KESSLER ST STE 140, MERRIAM, KS 66204-2519
(913) 362-8317
(913) 362-0169
Mailing address
7450 KESSLER ST STE 140, MERRIAM, KS 66204-2519
(913) 362-8317
(913) 362-0169
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
15-01380
KS
363AS0400X
Surgical Physician Assistant
Primary
1501380
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200674450C
—
KS
Enumeration date
07/15/2010
Last updated
01/20/2020
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