| Shoal Creek Family Medicine And Allergy, Pc | |
|
9784 N Ash Avenue Kansas City MO 64157 | |
| (816) 781-4244 | |
| (816) 781-3542 |
| Full Name | Shoal Creek Family Medicine And Allergy, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 9784 N Ash Avenue, Kansas City, Missouri |
| Authorized Official Name and Position | Wendy Renee Stapleton (PRACTICE MANAGER) |
| Authorized Official Contact | 8167814244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoal Creek Family Medicine And Allergy, Pc 9784 N Ash Avenue Kansas City MO 64157 Ph: (816) 781-4244 | Shoal Creek Family Medicine And Allergy, Pc 9784 N Ash Avenue Kansas City MO 64157 Ph: (816) 781-4244 |
| NPI Number | 1710056502 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710056502 | NPI | - | NPPES |
| 32015013 | Other | MO | BCBS GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 113071 (Missouri) | Primary |
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