MEDICARE: SAMUEL D HOEPER JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	04-25017	KS
2	207R00000X	Internal Medicine Physician	R5246	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700877792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL D HOEPER JR. MD

Provider Business Mailing Address
First Line	:	6420 PROSPECT AVE
Second Line	:	SUITE T101
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-4147
Country	:	US
Telephone Number	:	816-363-4100
Fax Number	:	816-363-4393

Provider Business Practice Location Address
First Line	:	2330 E MEYER BLVD
Second Line	:	SUITE 101
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-1132
Country	:	US
Telephone Number	:	816-276-9800
Fax Number	:	816-363-4393

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	01/25/2022

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Directions to “ SAMUEL D HOEPER JR. MD” Practice Location

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