PLASTIC SURGERY CENTER OF ST JOSEPH, INC
Surgery Yellow Pages
Saint Joseph, Missouri
Provider NPI: 1508862996
Organization Information:Organization Name: PLASTIC SURGERY CENTER OF ST JOSEPH, INC
Practice Location:
2111 N WOODBINE RD SAINT JOSEPH, MO 64506 US
Tel: 816-364-6416 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
2111 N WOODBINE RD SAINT JOSEPH, MO 64506 US
Tel: 816-364-6416 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 261QA1903X | Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical | MO | 136-0 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
509336905 | MO | 05 | |
STATE LICENSE NUMBER | 136-0 | MO | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin