Individual
EVERETTE THEODORE SITZMAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5200 W 94TH TER, STE 105, PRAIRIE VILLAGE, KS 66207-2522
(913) 649-5567
(913) 649-7563
Mailing address
5200 W 94TH TER, STE 105, PRAIRIE VILLAGE, KS 66207-2522
(913) 649-5567
(913) 649-7563
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
04 22079
KS
2084P0805X
Geriatric Psychiatry Physician
04 22079
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15094011
BC BS OF KC
—
Enumeration date
01/10/2006
Last updated
05/25/2010
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