Healthcare Provider Details

I. General information

NPI: 1538149323
Provider Name (Legal Business Name): MEDICAL PLAZA CONSULTANTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 03/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 WORNALL RD SUITE 530
KANSAS CITY MO
64111-5941
US

IV. Provider business mailing address

4320 WORNALL RD SUITE 530
KANSAS CITY MO
64111-5941
US

V. Phone/Fax

Practice location:
  • Phone: 816-753-4312
  • Fax: 816-753-2293
Mailing address:
  • Phone: 816-753-4312
  • Fax: 816-753-2293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHRYN S VANCE
Title or Position: ADMINISTRATOR
Credential:
Phone: 816-303-0232