Provider Demographics
NPI:1205898038
Name:HEAD AND NECK SURGICAL ASSOCIATES, PA
Entity type:Organization
Organization Name:HEAD AND NECK SURGICAL ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:MASLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-663-5100
Mailing Address - Street 1:5520 COLLEGE BLVD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1630
Mailing Address - Country:US
Mailing Address - Phone:913-663-5100
Mailing Address - Fax:913-663-3354
Practice Address - Street 1:5520 COLLEGE BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1630
Practice Address - Country:US
Practice Address - Phone:913-663-5100
Practice Address - Fax:913-663-3354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-21348207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSK800000Medicare PIN
MOK800000AMedicare PIN