Organization
NOVAMED EYE SURGERY CENTER OF OVERLAND PARK, LLC
Active
Other names
Overland Park Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5900
Entity
Organization
Contact information
Practice address
5520 COLLEGE BLVD, SUITE 200, OVERLAND PARK, KS 66211-1630
(913) 491-3040
(913) 491-3640
Mailing address
5520 COLLEGE BLVD, SUITE 200, OVERLAND PARK, KS 66211-1630
(913) 491-3040
(913) 491-3640
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
S-046-005
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100279090A
—
KS
01
—
490003071
RR MEDICARE
—
05
—
508157302
—
MO
Enumeration date
07/28/2005
Last updated
10/13/2020
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