Basic Information
| Provider Information | |||||||||
| NPI: | 1447489562 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIENHOP | ||||||||
| FirstName: | TUCKER | ||||||||
| MiddleName: | EVAN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10200 NE 103RD ST | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641578019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163087089 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2316 E MEYER BLVD | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641321136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162764155 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2009 | ||||||||
| LastUpdateDate: | 04/10/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 2012009154 | MO | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.