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General NPI Number Information
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NPI Number | 1588138820
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Entity Type | Organization
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Legal Business Name | CLAY PLATTE FAMILY MEDICINE CLINIC
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Dates
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Enumeration Date | 01/21/2019
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 3601 NE RALPH POWELL RD STE D
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City | LEES SUMMIT
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State | MO
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Zip | 64064-2358
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Country | US
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Telephone | 816-842-4440
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Fax |
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Provider Business Mailing Address
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Address Line | 5501 NW 62ND TER STE 100
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City | KANSAS CITY
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State | MO
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Zip | 64151-2412
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Country | US
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Telephone | 816-842-4440
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT H KUENNEN
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Credential | MD
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Telephone | 816-842-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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