# MIDWEST DOCTORS GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mid-America Sports Medicine and Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841462314
- **Authorized official:** PATRICK J KUENY (VICE PRESIDENT)
- **Authorized official phone:** (816) 508-4090

## Contact information

- **Practice address:** 19550 E 39TH ST S, SUITE 419, INDEPENDENCE, MO 64057-2303
- **Practice address phone:** (816) 795-8200
- **Practice address fax:** (816) 795-7735
- **Mailing address:** 19550 E 39TH ST S, SUITE 419, INDEPENDENCE, MO 64057-2303
- **Mailing address phone:** (816) 795-8200
- **Mailing address fax:** (816) 795-7735

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | Yes |
| 208M00000X | Hospitalist Physician | — | NULL | — |
| 208M00000X | Hospitalist Physician | — | — | — |

## Other

- **Enumeration date:** 03/25/2008
- **Last updated:** 12/16/2009