| James E Gracheck, D O P C | |
|
106 W 72nd St Kansas City MO 64114-5702 | |
| (816) 444-0025 | |
| (816) 444-0007 |
| Full Name | James E Gracheck, D O P C |
|---|---|
| Speciality | Family Medicine |
| Location | 106 W 72nd St, Kansas City, Missouri |
| Authorized Official Name and Position | James E Gracheck (OWNER) |
| Authorized Official Contact | 8164440025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James E Gracheck, D O P C 8607 E 77th St Kansas City MO 64138-1210 Ph: (816) 358-1231 | James E Gracheck, D O P C 106 W 72nd St Kansas City MO 64114-5702 Ph: (816) 444-0025 |
| NPI Number | 1023253176 |
|---|---|
| Provider Enumeration Date | 12/03/2008 |
| Last Update Date | 02/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023253176 | NPI | - | NPPES |
| 240879205 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 33627 (Missouri) | Primary |
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