Provider Demographics
NPI:1982602678
Name:VANBIBER, JOSEPH ROY (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ROY
Last Name:VANBIBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W R D MIZE RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-2518
Mailing Address - Country:US
Mailing Address - Phone:816-228-4770
Mailing Address - Fax:816-228-1156
Practice Address - Street 1:205 W R D MIZE RD
Practice Address - Street 2:SUITE 304
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-2518
Practice Address - Country:US
Practice Address - Phone:816-228-4770
Practice Address - Fax:816-228-1156
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9E89208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
287900OtherFAMILY HEALTH PARTNERS
15341039OtherBLUE CROSS/BLUE SHIELD
287901OtherFAMILY HEALTH PARTNERS
1208117OtherUNITED HEALTH CARE
MO242479509Medicaid
4002008OtherAETNA
313340OtherFIRST GUARD