Healthcare Provider Details

I. General information

NPI: 1114913886
Provider Name (Legal Business Name): JAMES PIONTEK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 05/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 GLENN HENDREN DR
LIBERTY MO
64068-9625
US

IV. Provider business mailing address

PO BOX 804408
KANSAS CITY MO
64180-0001
US

V. Phone/Fax

Practice location:
  • Phone: 816-781-7200
  • Fax: 816-461-6586
Mailing address:
  • Phone: 816-461-8288
  • Fax: 816-461-6586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberR6978
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: