Healthcare Provider Details

I. General information

NPI: 1285773655
Provider Name (Legal Business Name): CRAIG I. SCHWARTZ, D.O., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E 104TH ST STE 150
KANSAS CITY MO
64131-4561
US

IV. Provider business mailing address

1300 E 104TH ST STE 150
KANSAS CITY MO
64131-4561
US

V. Phone/Fax

Practice location:
  • Phone: 913-451-8346
  • Fax: 913-451-8347
Mailing address:
  • Phone: 913-451-8346
  • Fax: 913-451-8347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number05-30131
License Number StateKS

VIII. Authorized Official

Name: DR. CRAIG I SCHWARTZ
Title or Position: OWNER-PRESIDENT
Credential: DO,FACOS,FICS,RPVI
Phone: 913-451-8346