-- JERRY L OLD -- M.D.
Individual Provider (NPI-1)
Active
Physical Medicine & Rehabilitation, Hospice and Palliative Medicine
Provider Information
- NPI Number
1285731752- Provider Type
- Individual Provider (NPI-1)
- Credentials
- M.D.
- Status
- Active
Contact & Location
- Address
- 15329 W 95TH ST, LENEXA, KS, 662191262
- Phone
- (913) 599-1125
- Fax
- (913) 599-3554
Specialties & Taxonomies
Physical Medicine & Rehabilitation, Hospice and Palliative Medicine
Primary License: KS #04-16260
Family Medicine
License: KS #04-16260