Provider Demographics
NPI:1891733556
Name:WESTERN MISSOURI BONE AND JOINT, INC.
Entity Type:Organization
Organization Name:WESTERN MISSOURI BONE AND JOINT, INC.
Other - Org Name:WESTERN MISSOURI IMAGING, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:BLISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:660-747-2228
Mailing Address - Street 1:510 FOSTER LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-3213
Mailing Address - Country:US
Mailing Address - Phone:660-747-2228
Mailing Address - Fax:660-747-7677
Practice Address - Street 1:510 FOSTER LN
Practice Address - Street 2:SUITE 101
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-3213
Practice Address - Country:US
Practice Address - Phone:660-747-2228
Practice Address - Fax:660-747-7677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOJ730000Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER