Healthcare Provider Details

I. General information

NPI: 1306242003
Provider Name (Legal Business Name): US MEDGROUP OF KANSAS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2014
Last Update Date: 11/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6542 MANCHESTER AVE
SAINT LOUIS MO
63139-3520
US

IV. Provider business mailing address

5080 SPECTRUM DR SUITE 1200 WEST
ADDISON TX
75001-4648
US

V. Phone/Fax

Practice location:
  • Phone: 314-647-0081
  • Fax: 314-647-5485
Mailing address:
  • Phone: 972-720-7772
  • Fax: 214-775-4502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ARTHUR ZIPORIN
Title or Position: PRESIDENT / TREASURER
Credential: MD
Phone: 913-894-6664