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NPI Code Detail

MEDICARE: ORTHOPEDIC ASSOCIATES OF JC, LLC

MEDICARE: ORTHOPEDIC ASSOCIATES OF JC, LLC
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
1207X00000XOrthopaedic Surgery PhysicianR3688MO
2207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1588164347
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORTHOPEDIC ASSOCIATES OF JC, LLC
Provider Business Mailing Address
First Line : 3709 S BOLGER CT
Second Line :
City : INDEPENDENCE
State : MO
Zip : 64055-3971
Country : US
Telephone Number : 816-729-1913
Fax Number : 855-862-9292
Provider Business Practice Location Address
First Line : 19201 E VALLEY VIEW PKWY STE C
Second Line :
City : INDEPENDENCE
State : MO
Zip : 64055-6913
Country : US
Telephone Number : 816-317-5070
Fax Number : 855-862-9292
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOHN WESLEY COLLINS JR.
Credential : MD
Telephone Number : 816-729-1913
Provider Enumeration Date : 02/19/2018
Last Update Date : 02/19/2018

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