| Jerry L Old, MD | |
|
15329 W 95th St, Lenexa, KS 66219-1262 | |
| (913) 599-1125 | |
| (913) 599-3554 |
| Full Name | Jerry L Old |
|---|---|
| Gender | Male |
| Speciality | Physical Medicine & Rehabilitation - Hospice And Palliative Medicine |
| Location | 15329 W 95th St, Lenexa, Kansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285731752 | NPI | - | NPPES |
| 614032 | Other | KS | FIRSTGUARD |
| 32423014 | Other | MO | BCBS KANSAS CITY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2081H0002X | Physical Medicine & Rehabilitation - Hospice And Palliative Medicine | 04-16260 (Kansas) | Primary |
| 207Q00000X | Family Medicine | 04-16260 (Kansas) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry L Old, MD 15329 W 95th St, Lenexa, KS 66219-1262 Ph: (913) 599-1125 | Jerry L Old, MD 15329 W 95th St, Lenexa, KS 66219-1262 Ph: (913) 599-1125 |
Stevie N Phillips, PTA Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 8325 Lenexa Dr, Lenexa, KS 66214 Phone: 888-652-9225 |