Provider Demographics
NPI:1720820780
Name:ROMTHERAPY KANSAS MEDICAL P.A.
Entity type:Organization
Organization Name:ROMTHERAPY KANSAS MEDICAL P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:STACY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-592-7743
Mailing Address - Street 1:101 SILVERMINE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2047
Mailing Address - Country:US
Mailing Address - Phone:888-374-0855
Mailing Address - Fax:
Practice Address - Street 1:13910 S BROUGHAM DR
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-2073
Practice Address - Country:US
Practice Address - Phone:888-374-0855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-11
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty