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NPI Code Detail

MEDICARE: DEBORAH L BUA MOT

MEDICARE: DEBORAH L BUA MOT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist2006011923MO
2225X00000XOccupational Therapist17-01557KS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3KA2868053OTHERKSMEDICARE PTAN
4MA4370075OTHERMOMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
146002038OTHERBCBS-KC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386779973
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH L BUA MOT
Provider Business Mailing Address
First Line : 8823 PRODUCTION LN
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-6511
Country : US
Telephone Number : 816-226-4011
Fax Number : 816-524-6115
Provider Business Practice Location Address
First Line : 10801 E STATE ROUTE 350
Second Line :
City : RAYTOWN
State : MO
Zip : 64138-2367
Country : US
Telephone Number : 816-737-5502
Fax Number : 816-737-5504
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 06/11/2014

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Directions to “ DEBORAH L BUA MOT” Practice Location

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