Provider Demographics
NPI:1790948065
Name:GASHLAND CLINIC PHYSICIANS INC
Entity Type:Organization
Organization Name:GASHLAND CLINIC PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KALTHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-436-7072
Mailing Address - Street 1:9411 N OAK TRFY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2233
Mailing Address - Country:US
Mailing Address - Phone:816-436-1800
Mailing Address - Fax:816-436-4241
Practice Address - Street 1:9411 N OAK TRFY
Practice Address - Street 2:SUITE 100
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2233
Practice Address - Country:US
Practice Address - Phone:816-436-1800
Practice Address - Fax:816-436-4241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO27037027OtherBCBS OF KC URGENT CARE LEGACY