Healthcare Provider Details
I. General information
NPI: 1073204673
Provider Name (Legal Business Name): P & C CONSULTANT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2023
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19600 E 39TH ST S
INDEPENDENCE MO
64057-2301
US
IV. Provider business mailing address
19600 E 39TH ST S
INDEPENDENCE MO
64057-2301
US
V. Phone/Fax
- Phone: 913-222-9779
- Fax: 816-312-4380
- Phone: 816-832-8006
- Fax: 816-670-2415
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VIJAY
PARTHIBAN
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 913-222-9779