Healthcare Provider Details

I. General information

NPI: 1326360546
Provider Name (Legal Business Name): SAINT LUKE'S PHYSICIAN PARTNERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2010
Last Update Date: 05/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4330 WORNALL RD SUITE 40
KANSAS CITY MO
64111-3201
US

IV. Provider business mailing address

4330 WORNALL RD SUITE 40
KANSAS CITY MO
64111-3201
US

V. Phone/Fax

Practice location:
  • Phone: 816-531-0930
  • Fax: 816-753-2671
Mailing address:
  • Phone: 816-531-0930
  • Fax: 816-753-2671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number StateMO

VIII. Authorized Official

Name: JULIE QUIRIN
Title or Position: CEO
Credential:
Phone: 816-932-9886