Organization
BRIAN K. HAITH DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN K HAITH DPM PA (PRESIDENT)
(913) 648-7440
Entity
Organization
Contact information
Practice address
4319 W 111TH TER, LEAWOOD, KS 66211-1701
(913) 648-7440
(913) 648-7440
Mailing address
4225 W. 107TH ST. #7310, OVERLAND PARK, KS 66207
(913) 648-7440
(913) 648-7440
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
504447202
—
MO
01
—
DD3689
RRPTAN
—
01
—
P22357013
BLUE CROSS BLUE SHIELD
MO
Enumeration date
05/16/2007
Last updated
10/28/2021
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