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Organization

MID AMERICA PATHOLOGY LABORATORY LLC

Active
Other names
Midwest Anatomic Pathology Laboratory LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RUSSELL LEE BENSON M.D. (PRESIDENT)
(913) 341-6297
Entity
Organization

Contact information

Practice address
7301 COLLEGE BLVD, SUITE 110, OVERLAND PARK, KS 66210-1937
(913) 341-6297
(913) 341-6299
Mailing address
PO BOX 52990, GREENWOOD, SC 29649-0048
(864) 223-3600
(864) 223-6054

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100364660A
KS
01
33818014
KANSAS CITY BCBS
MO
01
405042
BCBS
KS
05
704970607
MO
Enumeration date
04/11/2006
Last updated
10/26/2012
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