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General NPI Number Information
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NPI Number | 1902476187
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Entity Type | Organization
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Legal Business Name | SAINT LUKES PHYSICIAN GROUP INC
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 07/28/2021
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Provider Practice Location Address
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Address Line | 901 E 104TH ST MAILSTOP 3000E
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City | KANSAS CITY
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State | MO
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Zip | 64131-4517
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Country | US
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Telephone | 816-502-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 504938
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City | SAINT LOUIS
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State | MO
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Zip | 63150-4938
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Country | US
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Telephone | 816-502-8782
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JULIE MURPHY
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Credential |
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Telephone | 816-599-9563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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 #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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