Healthcare Provider Details

I. General information

NPI: 1609025782
Provider Name (Legal Business Name): CONCENTRA HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2008
Last Update Date: 05/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 OAK STREET
KANSAS CITY MO
64106
US

IV. Provider business mailing address

5080 SPECTRUM DRIVE SUITE 1200 WEST
ADDISON TX
75001-4625
US

V. Phone/Fax

Practice location:
  • Phone: 816-842-1146
  • Fax: 816-283-3603
Mailing address:
  • Phone: 972-364-8000
  • Fax: 214-775-4406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. KEITH W NEWTON
Title or Position: PRESIDENT
Credential: MD
Phone: 972-364-8000