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General NPI Number Information
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NPI Number | 1770456840
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Entity Type | Organization
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Legal Business Name | NEW LIBERTY HOSPITAL COPORATION
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 2521 GLENN HENDREN DR STE 202
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City | LIBERTY
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State | MO
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Zip | 64068-3388
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Country | US
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Telephone | 816-415-3472
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 219672
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City | KANSAS CITY
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State | MO
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Zip | 64121-9672
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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 | CHIEF OPERATING OFFICER
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Name | JOHN STATON
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Credential |
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Telephone | 816-792-7091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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