Organization
SHAWNEE MISSION PEDIATRICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT VINCENT JACKSON M.D. (PRESIDENT)
(913) 362-1660
Entity
Organization
Contact information
Practice address
8901 W 74TH ST, SUITE 10, OVERLAND PARK, KS 66204-2204
(913) 362-1660
(913) 362-5916
Mailing address
8901 W 74TH ST, SUITE 10, OVERLAND PARK, KS 66204-2204
(913) 362-1660
(913) 362-5916
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
09/29/2006
Last updated
08/22/2020
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