Organization
PROFESSIONAL EYECARE SOUTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN ANDERSEN MD (OWNER)
(402) 540-0017
Entity
Organization
Contact information
Practice address
6575 W 119TH ST, OVERLAND PARK, KS 66209-2001
(913) 696-0092
Mailing address
11121 W 95TH ST, OVERLAND PARK, KS 66214-1824
(913) 492-7728
(913) 492-5217
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
06/08/2020
Last updated
06/08/2020
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