Healthcare Provider Details
I. General information
NPI: 1083658066
Provider Name (Legal Business Name): ST LUKES HOSPITAL OF KANSAS CITY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4320 WORNALL RD SUITE 512
KANSAS CITY MO
64111-5941
US
IV. Provider business mailing address
4320 WORNALL RD SUITE 512
KANSAS CITY MO
64111-5941
US
V. Phone/Fax
- Phone: 816-753-5663
- Fax: 816-753-4701
- Phone: 816-753-5663
- Fax: 816-743-4701
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
KATHLEEN
G
SCRIBNER
Title or Position: OFFICE MANAGER
Credential:
Phone: 816-753-5663