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Organization

JASON WILTSHIRE MD AN OPERATING DIVISION OF PROVIDENCE MEDICAL CTR

Active
Parent organization
PROVIDENCE MEDICAL CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
PROVIDENCE MEDICAL CENTER
Authorized official
MR. MICHAEL A DORSEY (CEO, PROVIDENCE HEALTH)
(913) 596-4000
Entity
Organization

Contact information

Practice address
8919 PARALLEL PKWY, SUITE 206, KANSAS CITY, KS 66112-1636
(913) 334-6800
(913) 334-0875
Mailing address
PO BOX 12264, KANSAS CITY, KS 66112-0264
(913) 825-6512
(913) 328-7011

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
KS

Other

Enumeration date
07/31/2009
Last updated
07/31/2009
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