# EXCELSIOR SPRINGS PHYSICIAN CLINIC LLC

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

## Provider details

- **NPI number:** 1811232796
- **Authorized official:** MRS. ELIZABETH ANN HESTER (PATIENT FINANCIAL SERVICES DIRECTOR)
- **Authorized official phone:** (816) 629-2790

## Contact information

- **Practice address:** 1700 RAINBOW BLVD, EXCELSIOR SPRINGS, MO 64024-1182
- **Practice address phone:** (816) 630-6081
- **Practice address fax:** (816) 629-3661
- **Mailing address:** 1700 RAINBOW BLVD, EXCELSIOR SPRINGS, MO 64024-1182
- **Mailing address phone:** (816) 630-6081
- **Mailing address fax:** (816) 629-3661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/04/2012
- **Last updated:** 01/08/2014