Healthcare Provider Details

I. General information

NPI: 1649492240
Provider Name (Legal Business Name): GOWER FAMILY CARE CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 05/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 S HWY 169
GOWER MO
64454
US

IV. Provider business mailing address

303 S HWY 169
GOWER MO
64454
US

V. Phone/Fax

Practice location:
  • Phone: 816-424-6427
  • Fax: 816-424-3851
Mailing address:
  • Phone: 816-424-6427
  • Fax: 816-424-3851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2002008815
License Number StateMO

VIII. Authorized Official

Name: DR. STEVEN D BRUSHWOOD
Title or Position: PRESIDENT
Credential: DO
Phone: 816-424-6427