Individual
KEVIN M LATINIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14641 BRIAR ST, LEAWOOD, KS 66224-3766
(913) 555-5555
(913) 555-5555
Mailing address
14641 BRIAR ST, LEAWOOD, KS 66224-3766
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
04-30721
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200265790A
—
KS
05
—
205690217
—
MO
01
—
34107011
BCBS KC
MO
01
—
479360
FIRSTGUARD
KS
Enumeration date
09/06/2006
Last updated
05/05/2015
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