Organization
RADIOLOGY ASSOCIATES OF KANSAS CITY, LLC
Active
Other names
Skin Deep Laser & Vein
Organization subpart
No
Provider details
NPI number
Authorized official
MARK IDSTROM MD (PRESIDENT)
(913) 599-6777
Entity
Organization
Contact information
Practice address
4809 W 117TH ST, LEAWOOD, KS 66211-2051
(913) 327-8702
(913) 327-8701
Mailing address
9212 NIEMAN RD, OVERLAND PARK, KS 66214-1868
(913) 599-6777
(913) 599-3955
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
09/10/2008
Last updated
07/08/2009
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