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General NPI Number Information
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NPI Number | 1699774893
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Entity Type | Organization
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Legal Business Name | GATES HOSPITALISTS LLC
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 03/27/2021
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Provider Practice Location Address
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Address Line | 2750 CLAY EDWARDS DR STE 200A
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3237
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Country | US
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Telephone | 816-968-9320
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 256
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City | LIBERTY
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State | MO
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Zip | 64069-0256
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Country | US
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Telephone | 816-968-9320
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | STACEY MICHELLE GATES
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Credential |
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Telephone | 816-968-9320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2000174342
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License Number State | MO
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