Organization
SUBURBAN FAMILY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY HODGES (MANAGER)
(913) 888-0777
Entity
Organization
Contact information
Practice address
10640 W 87TH ST, OVERLAND PARK, KS 66214-1651
(913) 888-0777
(913) 780-0919
Mailing address
10640 W 87TH ST, OVERLAND PARK, KS 66214-1651
(913) 888-0777
(913) 780-0919
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
0413053
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05281017
BCBS KC
—
01
—
451869
BCBS KANSAS
KS
01
—
CS4716
RAILROAD MEDICARE
—
Enumeration date
09/27/2007
Last updated
09/27/2007
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