Provider Demographics
NPI:1053401539
Name:HYPERBARIC OXYGEN OF KANSAS CITY INC.
Entity type:Organization
Organization Name:HYPERBARIC OXYGEN OF KANSAS CITY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:MIZE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT, CHT
Authorized Official - Phone:816-943-4600
Mailing Address - Street 1:PO BOX 25065
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66225-5065
Mailing Address - Country:US
Mailing Address - Phone:816-946-4600
Mailing Address - Fax:816-943-4736
Practice Address - Street 1:1000 CARONDELET DRIVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4673
Practice Address - Country:US
Practice Address - Phone:816-943-4600
Practice Address - Fax:816-943-4736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOB630000Medicare PIN