| Johnson County Neurology Llc | |
|
5701 W 119th St Suite 102 Overland Park KS 66209-3722 | |
| (913) 661-9434 | |
| (913) 661-4688 |
| Full Name | Johnson County Neurology Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5701 W 119th St, Overland Park, Kansas |
| Authorized Official Name and Position | Patrick J. Kueny (VP) |
| Authorized Official Contact | 8165084090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Johnson County Neurology Llc 12140 Nall Suite 230 Overland Park KS 66209-2503 Ph: (913) 661-9434 | Johnson County Neurology Llc 5701 W 119th St Suite 102 Overland Park KS 66209-3722 Ph: (913) 661-9434 |
| NPI Number | 1194850115 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 07/28/2009 |
| Medicare PECOS PAC ID | 8224134226 |
|---|---|
| Medicare Enrollment ID | O20070508000664 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194850115 | NPI | - | NPPES |
| 507292209 | Medicaid | MO | |
| 200428250A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Stacy D Younger |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043212210 PECOS PAC ID: 4082634993 Enrollment ID: I20051206000683 |
| Provider Name | Robert Walter Jensen |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1083741961 PECOS PAC ID: 8224012737 Enrollment ID: I20120128000020 |
| Provider Name | David F Clark |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629230479 PECOS PAC ID: 8628218435 Enrollment ID: I20130722000423 |
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