Provider Demographics
NPI:1225505456
Name:NEW LIBERTY HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:NEW LIBERTY HOSPITAL CORPORATION
Other - Org Name:THE EAR, NOSE AND THROAT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESEIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:FEESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-781-7200
Mailing Address - Street 1:2609 GLENN HENDREN DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-3313
Mailing Address - Country:US
Mailing Address - Phone:816-781-7730
Mailing Address - Fax:
Practice Address - Street 1:2521 GLENN HENDREN DR STE 104
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-3388
Practice Address - Country:US
Practice Address - Phone:816-781-1001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-25
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty