MEDICARE: ST. LUKE'S HOSPITAL

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	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1437239191
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. LUKE'S HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 930036
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64193-0001
Country	:	US
Telephone Number	:	816-461-8288
Fax Number	:	816-461-6586

Provider Business Practice Location Address
First Line	:	4400 WORNALL RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3238
Country	:	US
Telephone Number	:	816-932-2392
Fax Number	:	816-461-6586

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	TONYA HACKET
Credential	:
Telephone Number	:	816-932-2392

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	08/22/2020

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Directions to “ST. LUKE'S HOSPITAL ” Practice Location

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