Healthcare Provider Details

I. General information

NPI: 1255761086
Provider Name (Legal Business Name): WRHAMAKER LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2013
Last Update Date: 11/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 E 122ND ST
KANSAS CITY MO
64145-1778
US

IV. Provider business mailing address

506 E 122ND ST
KANSAS CITY MO
64145-1778
US

V. Phone/Fax

Practice location:
  • Phone: 816-941-2849
  • Fax: 816-941-2849
Mailing address:
  • Phone: 816-941-2849
  • Fax: 816-941-2849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberR9094
License Number StateMO

VIII. Authorized Official

Name: WILLIAM RODNEY HAMAKER
Title or Position: PRESIDENT
Credential: MD
Phone: 816-941-2849