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Organization

JAYHAWK PRIMARY CARE INC

Active
Parent organization
JAYHAWK PRIMARY CARE INC
Other names
State Avenue Health Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
JAYHAWK PRIMARY CARE INC
Authorized official
MICHAEL OLSON (COO)
(913) 945-9740
Entity
Organization

Contact information

Practice address
4810 STATE AVE, STATE AVENUE HEALTH CARE, KANSAS CITY, KS 66102-1748
(913) 945-9740
(913) 945-9741
Mailing address
4810 STATE AVE, STATE AVENUE HEALTH CARE, KANSAS CITY, KS 66102-1748
(913) 945-9740
(913) 945-9741

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
12/04/2012
Last updated
12/04/2012
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