Organization
MID AMERICA EYE CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUE KALWEI C.O.A. (ADMINISTRATOR)
(913) 384-1441
Entity
Organization
Contact information
Practice address
3830 W 75TH ST, PRAIRIE VILLAGE, KS 66208-4128
(913) 384-1441
Mailing address
PO BOX 877448, KANSAS CITY, MO 64187-7448
(913) 384-1441
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22857015
KANSAS CITY BC/BS
MO
Enumeration date
07/04/2006
Last updated
11/07/2012
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