Individual
MARK S HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12200 W 106TH ST, SUITE 400, OVERLAND PARK, KS 66215-2305
(913) 541-8897
(913) 541-9135
Mailing address
12200 W 106TH ST, SUITE 400, OVERLAND PARK, KS 66215-2305
(913) 541-8897
(913) 541-9135
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0421147
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100114030A
—
KS
05
—
100114030B
—
KS
05
—
1386733731
—
MO
01
—
15113011
KC
—
Enumeration date
10/12/2006
Last updated
02/09/2022
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