Basic Information
| Provider Information | |||||||||
| NPI: | 1164665600 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEART SURGEONS OF KANSAS CITY, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4330 WORNALL RD | ||||||||
| Address2: | SUITE 50 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641113201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169313312 | ||||||||
| FaxNumber: | 8165319862 | ||||||||
| Practice Location | |||||||||
| Address1: | 4330 WORNALL RD | ||||||||
| Address2: | SUITE 50 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641113201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169313312 | ||||||||
| FaxNumber: | 8165319862 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2009 | ||||||||
| LastUpdateDate: | 06/04/2009 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | COLLEEN | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8169313312 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.