MEDICARE: URGENT SPECIALTY ASSOCIATES OF MISSOURI LLC

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	2086S0102X	Surgical Critical Care Physician

General Provider Information

NPI Number	:	1710615612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URGENT SPECIALTY ASSOCIATES OF MISSOURI LLC

Provider Business Mailing Address
First Line	:	13500 POWERS CT STE 230
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4503
Country	:	US
Telephone Number	:	817-856-0065
Fax Number	:

Provider Business Practice Location Address
First Line	:	2330 E MEYER BLVD STE 209
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-1149
Country	:	US
Telephone Number	:	816-235-3932
Fax Number	:	816-709-1193

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN D JOSEPHS
Credential	:	MD
Telephone Number	:	469-609-9908

Provider Enumeration Date	:	08/10/2022
Last Update Date	:	08/10/2022

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