Healthcare Provider Details

I. General information

NPI: 1033396577
Provider Name (Legal Business Name): SAINT LUKE'S HOSPITAL PHYSICIAN BILLING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 WORNALL RD SUITE 513
KANSAS CITY MO
64111-5941
US

IV. Provider business mailing address

PO BOX 504407
SAINT LOUIS MO
63150-0001
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-4500
  • Fax: 816-932-4635
Mailing address:
  • Phone: 816-932-7940
  • Fax: 816-932-7957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMA JOHNSON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 816-932-2589