Healthcare Provider Details

I. General information

NPI: 1821518630
Provider Name (Legal Business Name): NEW LIBERTY HOSPITAL COPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2017
Last Update Date: 04/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8380 N TULLIS AVE SUITE 300
KANSAS CITY MO
64158
US

IV. Provider business mailing address

PO BOX 219672
KANSAS CITY MO
64121-9672
US

V. Phone/Fax

Practice location:
  • Phone: 816-415-3451
  • Fax:
Mailing address:
  • Phone: 816-407-4555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID FEESS
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 816-781-7200