| Summit Family & Sports Medicine Clinic | |
|
3601 Ne Ralph Powell Rd Ste D Lees Summit MO 64064-2358 | |
| (816) 842-4440 | |
| Not Available |
| Full Name | Summit Family & Sports Medicine Clinic |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies |
| Location | 3601 Ne Ralph Powell Rd Ste D, Lees Summit, Missouri |
| Authorized Official Name and Position | Scott H Kuennen (PRESIDENT) |
| Authorized Official Contact | 8168424440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Family & Sports Medicine Clinic 5501 Nw 62nd Ter Ste 100 Kansas City MO 64151-2412 Ph: (816) 842-4440 | Summit Family & Sports Medicine Clinic 3601 Ne Ralph Powell Rd Ste D Lees Summit MO 64064-2358 Ph: (816) 842-4440 |
| NPI Number | 1588138820 |
|---|---|
| Provider Enumeration Date | 01/21/2019 |
| Last Update Date | 10/25/2022 |
| Medicare PECOS PAC ID | 3173424231 |
|---|---|
| Medicare Enrollment ID | O20130919000306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588138820 | NPI | - | NPPES |
| 6150520002 | Other | NSC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
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