# LIBERTY MEDICINE SPECIALISTS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194762930
- **Authorized official:** DONNA G WELCH (MANAGER)
- **Authorized official phone:** (816) 781-8100

## Contact information

- **Practice address:** 550 RUSH CREEK PKWY, STE B, LIBERTY, MO 64068-9604
- **Practice address phone:** (816) 781-8100
- **Practice address fax:** (816) 781-3374
- **Mailing address:** 550 RUSH CREEK PKWY, STE B, LIBERTY, MO 64068-9604
- **Mailing address phone:** (816) 781-8100
- **Mailing address fax:** (816) 781-3374

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 110760 | MO | — |
| 207R00000X | Internal Medicine Physician | R6J63 | MO | — |
| 207R00000X | Internal Medicine Physician | R8A47 | MO | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 109247 | MO | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | R4935 | MO | Yes |

## Other

- **Enumeration date:** 06/01/2006
- **Last updated:** 04/13/2009