NPI 1609966753

Adult and Pediatric Dermatology

Organisation Dermatology Physician Overland Park, KS

Practice location

Address: 4601 W 109th St STE 116, Overland Park, KS 66211-1313
Phone: (913) 469-1115
Fax: (913) 469-9192
Mailing address: 4601 W. 109th Street Suite 116, Overland Park, KS 66211-1313

Authorised official

Name: Jenean C Kemp
Title: Administrator
Phone: (913) 948-9184

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 0422209 (KS)

Other Dermatology providers in Kansas →

Registry record

NPI: 1609966753
Entity type: Organization
NPI issued: 12 Oct 2006
Record last updated: 13 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.