Provider Demographics
NPI:1174525208
Name:HENDRICKS, KARL D (MD)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:D
Last Name:HENDRICKS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8919 PARALLEL PKWY
Mailing Address - Street 2:STE 226
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-1655
Mailing Address - Country:US
Mailing Address - Phone:913-299-8800
Mailing Address - Fax:913-299-6581
Practice Address - Street 1:8919 PARALLEL PKWY
Practice Address - Street 2:STE 226
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1655
Practice Address - Country:US
Practice Address - Phone:913-299-8800
Practice Address - Fax:913-299-6581
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS18861207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSC52316Medicare UPIN
KS6546625Medicare ID - Type Unspecified