Healthcare Provider Details
I. General information
NPI: 1649283177
Provider Name (Legal Business Name): ST LUKES EAST ANESTHESIA SERVICES,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 NE SAINT LUKES BLVD
LEES SUMMIT MO
64086-6000
US
IV. Provider business mailing address
10310 STATE LINE RD STE A
LEAWOOD KS
66206-2695
US
V. Phone/Fax
- Phone: 816-347-5800
- Fax: 816-347-5899
- Phone: 913-647-4101
- Fax: 913-647-4121
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
MICHAEL
WARING
Title or Position: PRESIDENT
Credential: M.D.
Phone: 816-347-5800