Provider Demographics
NPI:1326386749
Name:NEW LIBERTY HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:NEW LIBERTY HOSPITAL CORPORATION
Other - Org Name:THE EXCELSIOR SPRINGS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:MR
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:PO BOX 219672
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64121-9672
Mailing Address - Country:US
Mailing Address - Phone:816-630-6071
Mailing Address - Fax:816-630-4465
Practice Address - Street 1:199 S MCCLEARY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024
Practice Address - Country:US
Practice Address - Phone:816-630-6071
Practice Address - Fax:816-630-4465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO17763056OtherBCBS