Provider Demographics
NPI:1467641076
Name:KANSAS CITY MEDICAL PARTNERS LLC
Entity Type:Organization
Organization Name:KANSAS CITY MEDICAL PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:E
Authorized Official - Last Name:CUEZZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-931-1278
Mailing Address - Street 1:3066 SW GRANDSTAND CIR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081
Mailing Address - Country:US
Mailing Address - Phone:913-215-5008
Mailing Address - Fax:
Practice Address - Street 1:3066 SW GRANDSTAND CIR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-3866
Practice Address - Country:US
Practice Address - Phone:913-215-5008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1002OtherMEDICARE PTAN
39522016OtherBLUE CROSS/BLUE SHIELD