Healthcare Provider Details

I. General information

NPI: 1720202161
Provider Name (Legal Business Name): HEALTHCARE ASSOCIATED EMERGENCY PHYSICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17065 S US 71 HIGHWAY
BELTON MO
64012
US

IV. Provider business mailing address

10975 BENSON ST SUITE 250
OVERLAND PARK KS
66210-1534
US

V. Phone/Fax

Practice location:
  • Phone: 816-348-1250
  • Fax: 816-348-1205
Mailing address:
  • Phone: 913-469-4244
  • Fax: 913-469-1939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK S HOLCOMB
Title or Position: PARTNER
Credential: MD
Phone: 913-469-4244