Provider Demographics
NPI:1790809234
Name:CERTIFIED SURGICAL FIRST ASSISTANTS OF KANSAS CITY
Entity Type:Organization
Organization Name:CERTIFIED SURGICAL FIRST ASSISTANTS OF KANSAS CITY
Other - Org Name:CSFA OF KC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYRONE
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:CSA, SA-C
Authorized Official - Phone:816-522-7899
Mailing Address - Street 1:14201 W 82ND ST
Mailing Address - Street 2:#2
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-4125
Mailing Address - Country:US
Mailing Address - Phone:816-522-7899
Mailing Address - Fax:913-302-0669
Practice Address - Street 1:14201 W 82ND ST
Practice Address - Street 2:#2
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-4125
Practice Address - Country:US
Practice Address - Phone:816-522-7899
Practice Address - Fax:913-302-0669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Multi-Specialty