Organization
KANSAS CITY BONE & JOINT CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE STEPHENSON CMPE (ADMINISTRATOR)
(913) 381-5225
Entity
Organization
Contact information
Practice address
10701 NALL AVE, SUITE 200, OVERLAND PARK, KS 66211-1231
(913) 381-5225
(913) 901-0186
Mailing address
10701 NALL AVE, SUITE 200, OVERLAND PARK, KS 66211-1231
(913) 381-5225
(913) 901-0186
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
—
—
363AS0400X
Surgical Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00616015
BCBS KC
—
Enumeration date
05/20/2006
Last updated
12/29/2009
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