Healthcare Provider Details

I. General information

NPI: 1447211537
Provider Name (Legal Business Name): LINTECUM & NICKELL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 WORNALL RD SUITE 720
KANSAS CITY MO
64111-5941
US

IV. Provider business mailing address

4320 WORNALL RD SUITE 720
KANSAS CITY MO
64111-5941
US

V. Phone/Fax

Practice location:
  • Phone: 816-531-2111
  • Fax: 816-531-6025
Mailing address:
  • Phone: 816-531-2111
  • Fax: 816-531-6025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. FREDERICK B LINTECUM
Title or Position: SECRETARY/TREASURER
Credential: M.D.
Phone: 816-531-2111