Provider Demographics
NPI:1225335250
Name:LEE'S SUMMIT PHYSICIANS GROUP
Entity Type:Organization
Organization Name:LEE'S SUMMIT PHYSICIANS GROUP
Other - Org Name:BLUE SPRINGS PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:WEINRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-524-3223
Mailing Address - Street 1:1600 NW SOUTH OUTER RD
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-2963
Mailing Address - Country:US
Mailing Address - Phone:816-554-6520
Mailing Address - Fax:
Practice Address - Street 1:1600 NW SOUTH OUTER RD
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-2963
Practice Address - Country:US
Practice Address - Phone:816-554-6520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty