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Constantine Lan Fotopoulos

Physical Medicine & Rehabilitation

Allopathic & Osteopathic Physicians

4320 Wornall Rd, Suite 610, Kansas City, MO 64111-5941

PECOS Enrollment

This provider is enrolled in PECOS as CONSTANTINE FOTOPOULOS.

Based on the most recent information from CMS, provider Constantine Lan Fotopoulos is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1023075272
Provider Type
Individual
Full Name
Fotopoulos, Constantine Lan
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
4/28/2006
Last Updated
2/9/2011

Contact Information

Practice Location

4320 Wornall Rd, Suite 610, Kansas City, MO 64111-5941

(913) 319-7600

(816) 531-4849

Mailing Location

3651 College Blvd, Leawood, KS 66211

(913) 319-7600

(913) 253-1702

Provider Taxonomies

Code	Description	License
Code 208100000X Primary	Description Physical Medicine & Rehabilitation Allopathic & Osteopathic Physicians	License 106257 Missouri
Code 208100000X	Description Physical Medicine & Rehabilitation Allopathic & Osteopathic Physicians	License 04-25099 Kansas

Constantine Lan Fotopoulos

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Hermes, Lisa Marie

St Lukes Hospital Of Kansas City

Eichenauer, Stefan

Probasco, Kathleen Ann

Kelly, Charles R

Martinez, Matthew Casey

Lee, Christopher

Poecker, Kimberly Jo