Organization
INTENSIVE DIABETES MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES T PAQUETTE (CEO)
(913) 596-4000
Entity
Organization
Contact information
Practice address
8919 PARALLEL PKWY, SUITE 360, KANSAS CITY, KS 66112-1636
(913) 596-3940
(913) 596-3950
Mailing address
PO BOX 12352, KANSAS CITY, KS 66112-0352
(913) 596-3940
(913) 596-3950
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34213011
BCBS KANSAS CITY
—
Enumeration date
10/01/2006
Last updated
08/22/2020
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