Healthcare Provider Details

I. General information

NPI: 1992326755
Provider Name (Legal Business Name): M P NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N MAIN ST STE 100
NEWTON KS
67114-2200
US

IV. Provider business mailing address

500 N MAIN ST STE 100
NEWTON KS
67114-2200
US

V. Phone/Fax

Practice location:
  • Phone: 816-388-0770
  • Fax:
Mailing address:
  • Phone: 816-388-0770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MORGAN RAY SHARP
Title or Position: PRESIDENT/CEO
Credential:
Phone: 816-388-0770