Basic Information
| Provider Information | |||||||||
| NPI: | 1649283177 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST LUKES EAST ANESTHESIA SERVICES,P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10310 STATE LINE RD STE A | ||||||||
| Address2: | |||||||||
| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662062695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136474101 | ||||||||
| FaxNumber: | 9136474121 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 NE SAINT LUKES BLVD | ||||||||
| Address2: | |||||||||
| City: | LEES SUMMIT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640866000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163475800 | ||||||||
| FaxNumber: | 8163475899 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | WARING | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | MICHAEL | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8163475800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 35587019 | 01 | MO | BCBS OF KANSAS CITY | OTHER |