Provider Demographics
NPI:1235460007
Name:QUINN PLASTIC SURGERY CENTER PC
Entity type:Organization
Organization Name:QUINN PLASTIC SURGERY CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:913-492-3443
Mailing Address - Street 1:6920 W 121ST ST
Mailing Address - Street 2:SUITE102
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2006
Mailing Address - Country:US
Mailing Address - Phone:913-492-3443
Mailing Address - Fax:913-492-1881
Practice Address - Street 1:6920 W 121ST ST
Practice Address - Street 2:SUITE102
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2006
Practice Address - Country:US
Practice Address - Phone:913-492-3443
Practice Address - Fax:913-492-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS421809174400000X
MOR5C63174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
971038OtherCOVENTRY HEALTH AND LIFE
275459OtherCOVENTRY MAIL HANDLERS
17471OtherCOVENTRY OF KS
275459OtherCOVENTRY UNIV OF MO
12900023OtherBLUE CROSS BLUE SHIELD
1795OtherCOVENTRY HEALTH PLAN
12900023OtherBLUE CROSS BLUE SHIELD
B55883Medicare UPIN