Provider Demographics
NPI:1235186941
Name:ROCKHILL GENERAL SURGERY LLC
Entity Type:Organization
Organization Name:ROCKHILL GENERAL SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-995-3015
Mailing Address - Street 1:6675 HOLMES RD
Mailing Address - Street 2:SUITE 550
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1150
Mailing Address - Country:US
Mailing Address - Phone:816-995-3015
Mailing Address - Fax:
Practice Address - Street 1:6675 HOLMES RD
Practice Address - Street 2:SUITE 550
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1150
Practice Address - Country:US
Practice Address - Phone:816-995-3015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS29460028OtherBCBS OF KANSAS - ROCKHILL
MO23902020OtherBCBS OF KC - TOWN PLAZA
MO11372027OtherBCBS OF KC - MENORAH
KS29460028OtherBCBS OF KANSAS - ROCKHILL