Provider Demographics
NPI:1912999277
Name:SWEENEY, CABOT LEE (MD)
Entity Type:Individual
Prefix:
First Name:CABOT
Middle Name:LEE
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 NW MURRAY RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-1204
Mailing Address - Country:US
Mailing Address - Phone:816-524-2626
Mailing Address - Fax:816-524-0173
Practice Address - Street 1:600 NW MURRAY RD
Practice Address - Street 2:SUITE 210
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-1204
Practice Address - Country:US
Practice Address - Phone:816-524-2626
Practice Address - Fax:816-524-0173
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS421945207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200014009Medicaid
KS200305720 CMedicaid
E53912Medicare UPIN
KS200305720 CMedicaid
MON88E445Medicare PIN