Basic Information
| Provider Information | |||||||||
| NPI: | 1588787501 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PULMONARY PHYSICIANS OF KANSAS CITY, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1004 CARONDELET DR | ||||||||
| Address2: | SUITE 410 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641144802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163896100 | ||||||||
| FaxNumber: | 8163896150 | ||||||||
| Practice Location | |||||||||
| Address1: | 1004 CARONDELET DR | ||||||||
| Address2: | SUITE 410 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641144802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163896100 | ||||||||
| FaxNumber: | 8163896150 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 11/06/2007 | ||||||||
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| AuthorizedOfficialLastName: | MCDONALD | ||||||||
| AuthorizedOfficialFirstName: | AMIE | ||||||||
| AuthorizedOfficialMiddleName: | L. | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8163896100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.