Healthcare Provider Details

I. General information

NPI: 1558329896
Provider Name (Legal Business Name): PATRICIA WEBSTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 12/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8124 NW LAKEVIEW DR
PARKVILLE MO
64152-4373
US

IV. Provider business mailing address

8124 NW LAKEVIEW DR
PARKVILLE MO
64152-4373
US

V. Phone/Fax

Practice location:
  • Phone: 816-746-0920
  • Fax:
Mailing address:
  • Phone: 816-746-0920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberR8H16
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: