Healthcare Provider Details

I. General information

NPI: 1689203580
Provider Name (Legal Business Name): JOSIAH THOMAS GREER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 WESTWOODS DR STE 100
LIBERTY MO
64068-3506
US

IV. Provider business mailing address

28 WESTWOODS DR STE 100
LIBERTY MO
64068-3506
US

V. Phone/Fax

Practice location:
  • Phone: 816-226-7045
  • Fax: 816-207-0452
Mailing address:
  • Phone: 816-226-7045
  • Fax: 816-207-0452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2023011542
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: