Organization
KANSAS MEDICAL CENTER, LLC
Active
Parent organization
KANSAS MEDICAL CENTER, LLC
Other names
KMC Physicians
Organization subpart
Yes
Provider details
NPI number
Legal business name
KANSAS MEDICAL CENTER, LLC
Authorized official
MR. STEVEN HADLEY (CHIEF BUSINESS EXECUTIVE)
(316) 300-4021
Entity
Organization
Contact information
Practice address
1124 W. 21ST ST, ANDOVER, KS 67002
(316) 300-4000
(316) 300-4040
Mailing address
PO BOX 268938, OKLAHOMA CITY, OK 73126-8938
(316) 300-4021
(316) 300-4040
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
KS
207Q00000X
Family Medicine Physician
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111283
BSBSKS
KS
05
—
200408390B
—
KS
01
—
DN3967
RR MEDICARE
KS
Enumeration date
05/24/2007
Last updated
11/10/2023
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