Provider Demographics
NPI:1467640235
Name:SHAVONNE L. DANNER, M.D., L.L.C.
Entity Type:Organization
Organization Name:SHAVONNE L. DANNER, M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-407-2028
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64069-0455
Mailing Address - Country:US
Mailing Address - Phone:816-407-2028
Mailing Address - Fax:816-407-4606
Practice Address - Street 1:2525 GLENN HENDEN DR
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068
Practice Address - Country:US
Practice Address - Phone:816-407-2028
Practice Address - Fax:816-407-4606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty