Individual
MARK LEE PEMBERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
7450 KESSLER ST STE 202, SHAWNEE MISSION, KS 66204-2553
(913) 632-9480
(913) 632-9499
Mailing address
7450 KESSLER ST STE 202, SHAWNEE MISSION, KS 66204-2553
(913) 632-9480
(913) 632-9499
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1500212
KS
Other
Enumeration date
03/29/2006
Last updated
03/20/2025
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