Provider Demographics
NPI:1477769123
Name:JEFFREY M BRICK MD PC
Entity Type:Organization
Organization Name:JEFFREY M BRICK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-333-5515
Mailing Address - Street 1:6724 TROOST AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1500
Mailing Address - Country:US
Mailing Address - Phone:816-333-5515
Mailing Address - Fax:816-361-9768
Practice Address - Street 1:6724 TROOST AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1500
Practice Address - Country:US
Practice Address - Phone:816-333-5515
Practice Address - Fax:816-361-9768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO32700261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty