Organization
MIDWEST SURGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEANN PENDLETON (MANAGER)
(913) 782-8577
Entity
Organization
Contact information
Practice address
20375 W 151ST ST, SUITE 463, OLATHE, KS 66061-7218
(913) 782-8577
(913) 782-2616
Mailing address
20375 W 151ST ST, SUITE 463, OLATHE, KS 66061-7218
(913) 782-8577
(913) 782-2616
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09368018
BCBS OF KANSAS CITY
—
05
—
100262960A
—
KS
01
—
CC9224
RAILROAD MEDICARE
—
Enumeration date
01/12/2007
Last updated
07/13/2010
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