Healthcare Provider Details

I. General information

NPI: 1467641076
Provider Name (Legal Business Name): KANSAS CITY MEDICAL PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 08/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3066 SW GRANDSTAND CIR
LEES SUMMIT MO
64081-3866
US

IV. Provider business mailing address

3066 SW GRANDSTAND CIR
LEES SUMMIT MO
64081
US

V. Phone/Fax

Practice location:
  • Phone: 913-215-5008
  • Fax:
Mailing address:
  • Phone: 913-215-5008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOY E CUEZZE
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 816-931-1278