Unknown Individual – Specialist, NPI 1417909672
Specialist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1741, Northeast Douglas Street, Lee's Summit, Jackson County, Missouri, 64086, United States
SUITE 102
LEES SUMMIT, MO 640864703
Phone: (816) 554-9955
Fax: (816) 554-6451
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 64086)
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