Provider Demographics
NPI:1740581305
Name:MIDWEST AMERICA PLASTIC SURGERY CENTER, LTD
Entity Type:Organization
Organization Name:MIDWEST AMERICA PLASTIC SURGERY CENTER, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HIEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-941-6226
Mailing Address - Street 1:1421 W 47TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-1103
Mailing Address - Country:US
Mailing Address - Phone:816-941-6226
Mailing Address - Fax:816-941-6336
Practice Address - Street 1:1421 W 47TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-1103
Practice Address - Country:US
Practice Address - Phone:816-941-6226
Practice Address - Fax:816-941-6336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1075372086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO00877303OtherARTICLE OF INCORPORATION FILE NUMBER