Provider Demographics
NPI:1003268087
Name:ADVANCED ORTHOPEDICS AND SPORTS MEDICINE
Entity Type:Organization
Organization Name:ADVANCED ORTHOPEDICS AND SPORTS MEDICINE
Other - Org Name:SANO ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:DAGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-525-2840
Mailing Address - Street 1:2861 NE INDEPENDENCE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2379
Mailing Address - Country:US
Mailing Address - Phone:816-525-2840
Mailing Address - Fax:816-525-2841
Practice Address - Street 1:2861 NE INDEPENDENCE AVE STE 201
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2379
Practice Address - Country:US
Practice Address - Phone:816-525-2840
Practice Address - Fax:816-525-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-01
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty