Organization
STATLAND CLINIC LTD
Active
Organization
STATLAND CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE SNYDER MD (PRESIDENT)
(913) 345-8500
Entity
Organization
Contact information
Practice address
5701 WEST 119TH ST, SUITE 240, OVERLAND PARK, KS 66209-3749
(913) 345-8500
(913) 345-3784
Mailing address
5701 WEST 119TH ST, SUITE 240, OVERLAND PARK, KS 66209-3749
(913) 345-8500
(913) 345-3784
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002170303A
—
KS
01
—
1769018
BLUE CROSS BLUE SHIELD
MO
01
—
CU0310
RAILROAD MEDICARE
—
Enumeration date
07/13/2006
Last updated
08/22/2020
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