Provider Demographics
NPI:1063683902
Name:SUNFLOWER MEDICAL GROUP, PA
Entity type:Organization
Organization Name:SUNFLOWER MEDICAL GROUP, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-299-3700
Mailing Address - Street 1:5675 ROE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROELAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66205
Mailing Address - Country:US
Mailing Address - Phone:913-432-2080
Mailing Address - Fax:913-432-5183
Practice Address - Street 1:5675 ROE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROELAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66205
Practice Address - Country:US
Practice Address - Phone:913-432-2080
Practice Address - Fax:913-432-5183
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNFLOWER MEDICAL GROUP, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-19
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS207Q00000X, 207R00000X, 207RN0300X, 2080A0000X, 2080P0202X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO36459012OtherKC BLUE SHIELD
KS100216770CMedicaid
MO36459012OtherKC BLUE SHIELD