Provider Demographics
NPI:1790004794
Name:RESEARCH FAMILY MEDICINE RESIDENCY
Entity Type:Organization
Organization Name:RESEARCH FAMILY MEDICINE RESIDENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENCY DIRECTOR ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-276-7600
Mailing Address - Street 1:6650 TROOST AVE
Mailing Address - Street 2:STE 305
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1215
Mailing Address - Country:US
Mailing Address - Phone:816-276-7600
Mailing Address - Fax:
Practice Address - Street 1:6650 TROOST AVE
Practice Address - Street 2:STE 305
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1215
Practice Address - Country:US
Practice Address - Phone:816-276-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-31
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010014291281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital