MEDICARE: BARTLETT FAMILY HEALTHCARE PC

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	:	1629189220
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARTLETT FAMILY HEALTHCARE PC

Provider Business Mailing Address
First Line	:	1236 N JESSE JAMES RD
Second Line	:
City	:	EXCELSIOR SPRINGS
State	:	MO
Zip	:	64024-1119
Country	:	US
Telephone Number	:	816-630-6699
Fax Number	:	816-637-2028

Provider Business Practice Location Address
First Line	:	1236 N JESSE JAMES RD
Second Line	:
City	:	EXCELSIOR SPRINGS
State	:	MO
Zip	:	64024-1119
Country	:	US
Telephone Number	:	816-630-6699
Fax Number	:	816-637-2028

Authorized Official
Title or Position	:	OWNER
Name	:	DANNY W BARTLETT
Credential	:	MD
Telephone Number	:	816-630-6699

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/24/2011

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