Provider Demographics
NPI:1679728000
Name:MIDWEST SLEEP SPECIALISTS LLC
Entity Type:Organization
Organization Name:MIDWEST SLEEP SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:HULL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-498-3003
Mailing Address - Street 1:3470 NE RALPH POWELL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2336
Mailing Address - Country:US
Mailing Address - Phone:913-498-3003
Mailing Address - Fax:913-341-5958
Practice Address - Street 1:3470 NE RALPH POWELL RD
Practice Address - Street 2:SUITE B
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2336
Practice Address - Country:US
Practice Address - Phone:913-498-3003
Practice Address - Fax:913-341-5958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO103504207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1362Medicare PIN
KSKA1365Medicare PIN
KSKA1519Medicare PIN
IAIB1363Medicare PIN
MOMA1666Medicare PIN
IAIB1756Medicare PIN