Healthcare Provider Details

I. General information

NPI: 1396007894
Provider Name (Legal Business Name): BRIAN WRIGHT ROE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 N RIVERSIDE RD STE 100
SAINT JOSEPH MO
64507-2566
US

IV. Provider business mailing address

902 N RIVERSIDE RD STE 100
SAINT JOSEPH MO
64507-2566
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-1241
  • Fax: 816-279-7794
Mailing address:
  • Phone: 816-271-1241
  • Fax: 816-279-7794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2019024490
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: