Provider Demographics
NPI:1063416477
Name:CONAWAY, JEFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:CONAWAY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9040 QUIVIRA RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-3902
Mailing Address - Country:US
Mailing Address - Phone:913-261-3153
Mailing Address - Fax:913-416-9704
Practice Address - Street 1:9040 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3902
Practice Address - Country:US
Practice Address - Phone:913-944-4900
Practice Address - Fax:913-416-9704
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1154652085R0202X
KS04-288512085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100416010AMedicaid
KS100416010BMedicaid
MO205788607Medicaid
KS101882Medicare PIN
H55866Medicare UPIN
KSJ96B618AMedicare PIN
KS100416010BMedicaid
MOJ96B618BMedicare PIN