Provider Demographics
NPI:1518932607
Name:LOONEY, STEVEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:C
Last Name:LOONEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 OAKLAND AVE, BOX 8252
Mailing Address - Street 2:
Mailing Address - City:ST JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64508-7515
Mailing Address - Country:US
Mailing Address - Phone:816-271-7648
Mailing Address - Fax:
Practice Address - Street 1:5325 FARAON ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3488
Practice Address - Country:US
Practice Address - Phone:816-271-6575
Practice Address - Fax:816-271-6139
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3G272085R0202X
KS04279572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO300138252OtherRR MEDICARE GROUP CK7871
KS100143780CMedicaid
MO202787123Medicaid
470768OtherBCBS KS FOR MO LOCATION
MO17685051OtherBCBS KANSAS CITY MO
KS106142OtherBCBS KS FOR KS LOCATION
MO17685051OtherBCBS KANSAS CITY MO
KS100143780CMedicaid
MO202787123Medicaid