Provider Demographics
NPI:1013989300
Name:MIDWEST NEUROSURGERY ASSOCIATES, PA
Entity Type:Organization
Organization Name:MIDWEST NEUROSURGERY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROUECHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-363-2500
Mailing Address - Street 1:6420 PROSPECT AVE
Mailing Address - Street 2:SUITE T411
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1180
Mailing Address - Country:US
Mailing Address - Phone:816-363-2500
Mailing Address - Fax:816-363-8741
Practice Address - Street 1:6420 PROSPECT AVE
Practice Address - Street 2:SUITE T411
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1180
Practice Address - Country:US
Practice Address - Phone:816-363-2500
Practice Address - Fax:816-363-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS2790000AMedicare ID - Type Unspecified
MO2790000Medicare ID - Type Unspecified