Organization
JAYHAWK PRIMARY CARE INC
Active
Parent organization
JAYHAWK PRIMARY CARE INC
Other names
CREEKWOOD FAMILY CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
JAYHAWK PRIMARY CARE INC
Authorized official
CARRIE JORDAN (CHIEF PRACTICE EXECUTIVE)
(913) 945-5592
Entity
Organization
Contact information
Practice address
6420 N PROSPECT AVE, GLADSTONE, MO 64119-1530
(913) 945-9700
(913) 945-9707
Mailing address
2330 SHAWNEE MISSION PKWY, MEDICAL ADMINISTRATIVE SERVICES OF KU MED. STE. 312, WESTWOOD, KS 66205-2005
(913) 945-5614
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10663011
BCBS GROUP NUMBR
MO
Enumeration date
04/05/2006
Last updated
06/13/2018
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