Old, Jerry L
Old, Jerry L is an individual health care provider with primary practice located at 15329 W 95Th St , Lenexa KS 66219-1262. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Old, Jerry L can be contacted via phone (913) 599-1125.Contact Information
Primary practice address
15329 W 95Th St
Lenexa KS 66219-1262
Phone: (913) 599-1125
Fax: (913) 599-3554
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 2081H0002X | 04-16260 | Kansas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 04-16260 | Kansas |
Profile Details
| NPI number | 1285731752 |
|---|---|
| LBN Legal business name | Old, Jerry L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285731752 | NPPES |
| Kansas | Other | 614032 | FIRSTGUARD |
| Kansas | Other | 32423014 | FIRSTGUARD |
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