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Organization

SHAWNEE FAMILY CARE PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARTHA A WARD CPC (OFFICE MANAGER)
(913) 631-6114
Entity
Organization

Contact information

Practice address
5949 NIEMAN RD, SHAWNEE, KS 66203-2907
(913) 631-6114
(913) 631-5263
Mailing address
5949 NIEMAN RD, SHAWNEE, KS 66203-2907
(913) 631-6114
(913) 631-5263

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0423330
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27992017
BLUE SHIELD GROUP
KS
01
CB6830
MEDICARE RR GROUP
KS
01
E66004
JOHN L CRANE UPIN
KS
01
H24932
UPIN MARY K DEVERS
KS
Enumeration date
02/16/2007
Last updated
08/22/2020
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