| NPI | 1104879055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ABERNATHY Director Of Finance 816-932-7941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2010-03-31 |