Healthcare Provider Details

I. General information

NPI: 1851456990
Provider Name (Legal Business Name): IAN M ROSBRUGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 CLAY EDWARDS DR STE 312
NORTH KANSAS CITY MO
64116-3256
US

IV. Provider business mailing address

2790 CLAY EDWARDS DR SUITE 530
NORTH KANSAS CITY MO
64116-3276
US

V. Phone/Fax

Practice location:
  • Phone: 816-691-1185
  • Fax: 816-346-7085
Mailing address:
  • Phone: 816-452-3300
  • Fax: 816-453-0677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2007011591
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number2007011591
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: