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General NPI Number Information
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NPI Number | 1891715652
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Entity Type | Organization
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Legal Business Name | HARRISONVILLE FAMILY MEDICINE, INC.
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 2820 E ROCK HAVEN RD SUITE 100
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City | HARRISONVILLE
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State | MO
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Zip | 64701-4411
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Country | US
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Telephone | 816-380-3582
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Fax | 816-380-6964
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Provider Business Mailing Address
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Address Line | 2820 E ROCK HAVEN RD SUITE 100
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City | HARRISONVILLE
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State | MO
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Zip | 64701-4411
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Country | US
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Telephone | 816-380-3582
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Fax | 816-380-6964
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHAUN HOLDEN
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Credential | M.D.
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Telephone | 816-380-3582
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | MO
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Taxonomy #3
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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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