Provider Demographics
NPI:1306133566
Name:KANSAS CITY SPORTS MEDICINE INC
Entity type:Organization
Organization Name:KANSAS CITY SPORTS MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PREM
Authorized Official - Middle Name:
Authorized Official - Last Name:PARMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-351-3005
Mailing Address - Street 1:712 1ST TER
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:KS
Mailing Address - Zip Code:66043-1735
Mailing Address - Country:US
Mailing Address - Phone:913-351-3005
Mailing Address - Fax:913-351-3009
Practice Address - Street 1:712 1ST TER
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:KS
Practice Address - Zip Code:66043-1735
Practice Address - Country:US
Practice Address - Phone:913-351-3005
Practice Address - Fax:913-351-3009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-28802207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty