is a Physician Assistant in Kansas City, Missouri. practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for is 1790896116. The last update date is .
's current location address is 4320 Wornall Rd Ste 50, Kansas City, Missouri. You can contact this provider via phone number 8169313312 and fax number 8165319862. The mailing address for is 4320 Wornall Rd Ste 50, Kansas City, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 4320 Wornall Rd Ste 50, Kansas City, Missouri |
| Phone Number | 8169313312 |
| Fax Number | 8165319862 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1790896116 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 4320 Wornall Rd Ste 50 |
|---|---|
| City | Kansas City |
| State | Missouri (MO) |
| Post Code | 641115943 |
| Phone Number | 8169313312 |
| Fax Number | 8165319862 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 15-00759 |
|
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 970017944 | RR MEDICARE | ||
| 10001686300 | CHP PROVIDER NUMBER | ||
| 928282 | FIRSTGUARD | ||
| 100391130A | KS | -- | |
| 481202402 | PSKU TAX ID |
Post Comment/ Review Below
Query execution failed: SQLSTATE[42000]: Syntax error or access violation: 1064 You have an error in your SQL syntax; check the manual that corresponds to your MariaDB server version for the right syntax to use near ') ORDER BY id ASC' at line 1
FAQs about
Other Providers of Physician Assistant