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General NPI Number Information
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NPI Number | 1427828102
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Entity Type | Organization
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Legal Business Name | INDEPENDENCE WOMENS CLINIC PC
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Dates
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Enumeration Date | 01/04/2024
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 19550 E 39TH ST S STE 300
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City | INDEPENDENCE
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State | MO
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Zip | 64057-2306
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Country | US
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Telephone | 816-478-0220
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Fax |
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Provider Business Mailing Address
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Address Line | 19550 E 39TH ST S STE 300
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City | INDEPENDENCE
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State | MO
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Zip | 64057-2306
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Country | US
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Telephone | 816-478-0220
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TIMOTHY HALL
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Credential | MD
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Telephone | 816-478-0220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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