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General NPI Number Information
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NPI Number | 1619404829
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Entity Type | Organization
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Legal Business Name | DONNER SUMMIT, LLC
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 08/11/2017
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Provider Practice Location Address
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Address Line | 9151 NE 81ST TER STE 240
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City | KANSAS CITY
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State | MO
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Zip | 64158-1307
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Country | US
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Telephone | 816-977-3291
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Fax |
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Provider Business Mailing Address
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Address Line | 9151 NE 81ST TER SUITE 240
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City | KANSAS CITY
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State | MO
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Zip | 64158
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Country | US
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Telephone | 816-977-3291
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN BILLHARZ
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Credential | MD
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Telephone | 816-977-3291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2010037363
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License Number State | MO
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