Healthcare Provider Details

I. General information

NPI: 1104827781
Provider Name (Legal Business Name): LIBERTY EMERGENCY PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/21/2022
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 411375
KANSAS CITY MO
64141-1375
US

V. Phone/Fax

Practice location:
  • Phone: 816-792-7000
  • Fax:
Mailing address:
  • Phone: 816-781-9222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateMO

VIII. Authorized Official

Name: DR. BRIAN J ROBB
Title or Position: PRESIDENT
Credential: D.O.
Phone: 816-391-7597