Provider Demographics
NPI:1770120784
Name:KANSAS CITY UROLOGY CARE, P.A.
Entity type:Organization
Organization Name:KANSAS CITY UROLOGY CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-341-7985
Mailing Address - Street 1:8551 BLUEJACKET ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1656
Mailing Address - Country:US
Mailing Address - Phone:913-341-7985
Mailing Address - Fax:
Practice Address - Street 1:17525 MEDICAL CENTER PKWY
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1824
Practice Address - Country:US
Practice Address - Phone:816-994-3151
Practice Address - Fax:816-359-3044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site