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General NPI Number Information
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NPI Number | 1669207775
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Entity Type | Organization
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Legal Business Name | SHIRKEY DIVERSIFIED HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 09/06/2024
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 701 WOLLARD BLVD
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City | RICHMOND
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State | MO
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Zip | 64085-2206
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Country | US
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Telephone | 816-776-5403
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Fax |
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Provider Business Mailing Address
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Address Line | 701 WOLLARD BLVD
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City | RICHMOND
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State | MO
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Zip | 64085-2206
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHRIS BROWN
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Credential |
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Telephone | 816-776-5403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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