Provider Demographics
NPI:1457561573
Name:MIDWEST CERTIFIED FIRST ASSISTANTS
Entity Type:Organization
Organization Name:MIDWEST CERTIFIED FIRST ASSISTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRST ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:EVERETTE
Authorized Official - Suffix:
Authorized Official - Credentials:SA-C
Authorized Official - Phone:816-358-4316
Mailing Address - Street 1:PO BOX 300674
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64130-0674
Mailing Address - Country:US
Mailing Address - Phone:816-358-4316
Mailing Address - Fax:
Practice Address - Street 1:7619 E 76TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64138-1121
Practice Address - Country:US
Practice Address - Phone:816-358-4316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO246ZS0400X246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty