Healthcare Provider Details
I. General information
NPI: 1437273430
Provider Name (Legal Business Name): ROBINE MEDICAL ASSOCIATES OF KANSAS CITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2007
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4200 LITTLE BLUE PKWY SUITE 300
INDEPENDENCE MO
64057-8312
US
IV. Provider business mailing address
4200 LITTLE BLUE PKWY SUITE 300
INDEPENDENCE MO
64057-8312
US
V. Phone/Fax
- Phone: 816-353-2700
- Fax: 816-795-7311
- Phone: 816-353-2700
- Fax: 816-795-7311
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | R7N57 |
| License Number State | MO |
VIII. Authorized Official
Name: MISS
JENNIFER
D
SCHULTZ
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 816-353-2700