Provider Demographics
NPI: | 1831613371 |
---|---|
Name: | EMERGENCY STAFFING SOLUTIONS OF KIRKSVILLE LLC |
Entity type: | Organization |
Organization Name: | EMERGENCY STAFFING SOLUTIONS OF KIRKSVILLE LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RON |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WEISS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 866-931-8882 |
Mailing Address - Street 1: | 17304 PRESTON RD STE 1400 |
Mailing Address - Street 2: | |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75252-5633 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 866-931-8882 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 315 S OSTEOPATHY AVE |
Practice Address - Street 2: | |
Practice Address - City: | KIRKSVILLE |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63501-6401 |
Practice Address - Country: | US |
Practice Address - Phone: | 660-785-1000 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | EMERGENCY STAFFING SOLUTIONS INC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2017-07-26 |
Last Update Date: | 2017-07-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty |