Healthcare Provider Details

I. General information

NPI: 1730280819
Provider Name (Legal Business Name): VAS-NES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 08/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2521 GLENN HENDREN DR SUITE 410
LIBERTY MO
64068-3388
US

IV. Provider business mailing address

2521 GLENN HENDREN DR SUITE 410
LIBERTY MO
64068-3388
US

V. Phone/Fax

Practice location:
  • Phone: 816-792-0010
  • Fax: 816-407-1066
Mailing address:
  • Phone: 816-792-0010
  • Fax: 816-407-1066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR5J39
License Number StateMO

VIII. Authorized Official

Name: DOUGLAS WAYNE NESPORY
Title or Position: PRESIDENT
Credential: D.O.
Phone: 816-792-0010