| Independence Regional Medical Group Llc | |
|
17421 Medical Center Pkwy Independence MO 64057-1805 | |
| (816) 356-2000 | |
| (816) 737-1796 |
| Full Name | Independence Regional Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 17421 Medical Center Pkwy, Independence, Missouri |
| Authorized Official Name and Position | Louis R Joseph (VP) |
| Authorized Official Contact | 6153737600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Regional Medical Group Llc 17421 Medical Center Pkwy Independence MO 64057-1805 Ph: (816) 356-2000 | Independence Regional Medical Group Llc 17421 Medical Center Pkwy Independence MO 64057-1805 Ph: (816) 356-2000 |
| NPI Number | 1922054295 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 04/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922054295 | NPI | - | NPPES |
| 506088202 | Medicaid | MO | |
| 100452440A | Medicaid | KS | |
| 100452440B | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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