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Organization

EMERGENCY MEDICINE SERVICES OF MO, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. VYVYAN DEROUEN (PRESIDENT)
(615) 376-5076
Entity
Organization

Contact information

Practice address
19600 E 39TH ST S, INDEPENDENCE, MO 64057-2301
(816) 698-7000
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 373-7406

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Enumeration date
02/09/2023
Last updated
11/20/2025
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