Organization
JOHNSON COUNTY DERMATOLOGY P.A.
Active
Organization
JOHNSON COUNTY DERMATOLOGY P.A.
Active
Other names
John L. Proffitt, M.D., P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
JAN-MARIE KROH M.D. (PRESIDENT)
(913) 764-1125
Entity
Organization
Contact information
Practice address
153 W 151ST ST, SUITE 100, OLATHE, KS 66061-5348
(913) 764-1125
(913) 764-1186
Mailing address
153 W 151ST ST, SUITE 100, OLATHE, KS 66061-5348
(913) 764-1125
(913) 764-1186
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE7997
RAILROAD MEDICARE
KS
Enumeration date
04/20/2011
Last updated
04/20/2011
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