Individual
DR. JOHN ANDREW BUKATY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4925 JUNIPER DR, ROELAND PARK, KS 66205-1253
(913) 362-4825
Mailing address
4925 JUNIPER DR, ROELAND PARK, KS 66205-1253
(913) 362-4825
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2004012747
MO
207Q00000X
Family Medicine Physician
Primary
31267
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588634224
—
MO
05
—
200355030F
—
KS
01
—
GROUP P530000
RR MEDICARE
MO
01
—
INDIVIDUAL P5300002
RR MEDICARE
MO
01
—
P00607207
RAILROAD MEDICARE
MO
Enumeration date
01/25/2006
Last updated
11/16/2009
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