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Organization
DR. J.A. DIRENNA JR, P.C.
Active
Organization
DR. J.A. DIRENNA JR, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES A DIRENNA JR. DO (DIRECTOR)
(816) 225-1643
Entity
Organization
Contact information
Practice address
1 THE WOODLANDS, GLADSTONE, MO 64119-1853
(816) 225-1643
(913) 248-9383
Mailing address
PO BOX 2181, INDEPENDENCE, MO 64055-0081
(913) 248-9693
(913) 248-9383
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R6C32
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19739014
BLUE SHIELD KC
MO
Enumeration date
02/13/2007
Last updated
08/22/2020
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