Healthcare Provider Details

I. General information

NPI: 1740276567
Provider Name (Legal Business Name): NEW LIBERTY MEDICAL & HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W CLAY AVE
PLATTSBURG MO
64477-1424
US

IV. Provider business mailing address

400 W CLAY AVE
PLATTSBURG MO
64477-1424
US

V. Phone/Fax

Practice location:
  • Phone: 816-539-2117
  • Fax: 816-539-3301
Mailing address:
  • Phone: 816-539-2117
  • Fax: 816-539-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID H FEESS
Title or Position: MANAGING EMPLOYEE
Credential:
Phone: 816-415-3460