MD Diversified Services LLC

NPI #1871534248 in Lenexa, Kansas

Provider Information

NPI Number: 1871534248
Entity Type: Organization
Organization Name: MD Diversified Services LLC
Primary Specialty: Family Medicine
Enumeration Date: Jun 9, 2006
Last Updated: Aug 4, 2010

Practice Location

Address: 23401 PRAIRIE STAR PKWY
Address 2: SUITE 120
City: Lenexa
State: Kansas
ZIP Code: 66227-7268
Phone: (913) 676-8600

Authorized Official

Name: THEO J FELTS, MD
Title: SOLE MEMBER LLC
Phone: (913) 322-8859

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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