Healthcare Provider Details

I. General information

NPI: 1679728000
Provider Name (Legal Business Name): MIDWEST SLEEP SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2008
Last Update Date: 01/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3470 NE RALPH POWELL RD SUITE B
LEES SUMMIT MO
64064-2336
US

IV. Provider business mailing address

3470 NE RALPH POWELL RD SUITE B
LEES SUMMIT MO
64064-2336
US

V. Phone/Fax

Practice location:
  • Phone: 913-498-3003
  • Fax: 913-341-5958
Mailing address:
  • Phone: 913-498-3003
  • Fax: 913-341-5958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number103504
License Number StateMO

VIII. Authorized Official

Name: STEVEN G HULL
Title or Position: OWNER
Credential: MD
Phone: 913-498-3003