Individual
LYDIA PREVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4401 W 109TH ST, OVERLAND PARK, KS 66211-1303
(913) 345-1400
Mailing address
4401 W 109TH ST, OVERLAND PARK, KS 66211-1303
(913) 345-1400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-48396
KS
Other
Enumeration date
03/15/2018
Last updated
10/04/2023
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