MEDICARE: WESTERN MISSOURI MEDICAL CENTER

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1407603855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN MISSOURI MEDICAL CENTER

Provider Business Mailing Address
First Line	:	403 BURKARTH RD
Second Line	:
City	:	WARRENSBURG
State	:	MO
Zip	:	64093-3101
Country	:	US
Telephone Number	:	660-262-7721
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 S MAIN ST
Second Line	:
City	:	CONCORDIA
State	:	MO
Zip	:	64020-8335
Country	:	US
Telephone Number	:	660-463-7966
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MICHAEL DEAN OHMART
Credential	:
Telephone Number	:	660-262-7307

Provider Enumeration Date	:	05/03/2024
Last Update Date	:	05/03/2024

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Directions to “WESTERN MISSOURI MEDICAL CENTER ” Practice Location

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