=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558531426
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WESTOWNE SURGICAL SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2008
-----------------------------------------------------
Last Update Date | 05/26/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2521 GLENN HENDREN DR STE 108
-----------------------------------------------------
City | LIBERTY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64068
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-781-3515
-----------------------------------------------------
Fax | 816-781-3517
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2521 GLENN HENDREN DR STE 108
-----------------------------------------------------
City | LIBERTY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64068
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-781-3515
-----------------------------------------------------
Fax | 816-781-3517
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CHARLES W BEGGS
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 816-781-3515
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | R4F32
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------