1114974607 NPI number — HARRY LOUNCE MD

Table of content: HARRY LOUNCE MD (NPI 1114974607)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114974607 NPI number — HARRY LOUNCE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOUNCE
Provider First Name:
HARRY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114974607
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2330 SHAWNEE MISSION PKWY
Provider Second Line Business Mailing Address:
MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
Provider Business Mailing Address City Name:
WESTWOOD
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66205-2005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-588-9000
Provider Business Mailing Address Fax Number:
913-588-9822

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12121 BLUE RIDGE EXT
Provider Second Line Business Practice Location Address:
BLUE RIDGE FAMILY PHYSICIANS, STE. M
Provider Business Practice Location Address City Name:
GRANDVIEW
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64030-6401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-761-0884
Provider Business Practice Location Address Fax Number:
816-716-1790
Provider Enumeration Date:
05/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  36186 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 157695XX . This is a "PREFERRED CARE OF NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2054542 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10204081 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 481159444 . This is a "JAYHAWK TAX ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 080160972 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10001636300 . This is a "CHP" identifier . This identifiers is of the category "OTHER".




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