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1588662282

NPI Code Detail

MEDICARE: STACEY LEIGH SHARPE MD

MEDICARE: STACEY LEIGH SHARPE MD

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	208000000X	Pediatrics Physician	005559	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1201586	OTHER		UNITED HEALTH CARE
2	31505012	OTHER		BLUE CROSS/BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	7351363	OTHER		AETNA
5	000567	OTHER		FAMILY HEALTH PARTNERS
6	506270	OTHER		FIRST GUARD

General Provider Information

NPI Number	:	1588662282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY LEIGH SHARPE MD

Provider Business Mailing Address
First Line	:	205 W R D MIZE RD
Second Line	:	SUITE 304
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2518
Country	:	US
Telephone Number	:	816-655-0125
Fax Number	:	816-228-1156

Provider Business Practice Location Address
First Line	:	205 W R D MIZE RD
Second Line	:	SUITE 304
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2518
Country	:	US
Telephone Number	:	816-655-0125
Fax Number	:	816-228-1156

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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Directions to “ STACEY LEIGH SHARPE MD” Practice Location

Language	Start Address	Practice Location

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