Basic Information
| Provider Information | |||||||||
| NPI: | 1851352140 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROCKHILL ORTHOPAEDICS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 NE SAINT LUKES BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | LEES SUMMIT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640866011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162464302 | ||||||||
| FaxNumber: | 8162468910 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 NE SAINT LUKES BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | LEES SUMMIT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640866011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162464302 | ||||||||
| FaxNumber: | 8162468910 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2006 | ||||||||
| LastUpdateDate: | 11/17/2009 | ||||||||
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| AuthorizedOfficialLastName: | DUGAN | ||||||||
| AuthorizedOfficialFirstName: | GERALD | ||||||||
| AuthorizedOfficialMiddleName: | FRANCIS | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8162464302 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | C50423 | 01 | MO | MEDICARE RAILROAD | OTHER | 00494014 | 01 | MO | BCBS | OTHER |