Basic Information
| Provider Information | |||||||||
| NPI: | 1598886285 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST LUKES HOSPITAL OF KANSAS CITY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 930841 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641930001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169313013 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4400 BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641113498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169313013 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2007 | ||||||||
| LastUpdateDate: | 04/08/2009 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | JAMA | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8169322000 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ST. LUKES HOSPITAL OF KANSAS CITY | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 208100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.