Healthcare Provider Details

I. General information

NPI: 1295753010
Provider Name (Legal Business Name): KANSAS CITY METROPOLITAN EAR NOSE & THROAT PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9411 N OAK TRAFFICWAY SUITE 202
KANSAS CITY MO
64155
US

IV. Provider business mailing address

9411 N OAK TRAFFICWAY SUITE 202
KANSAS CITY MO
64155
US

V. Phone/Fax

Practice location:
  • Phone: 816-468-8820
  • Fax: 816-468-8898
Mailing address:
  • Phone: 816-468-8820
  • Fax: 816-468-8898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: NATHAN D BURROUGHS
Title or Position: PRESIDENT OF CORPORATION
Credential: MD
Phone: 816-468-8820