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Organization

CARONDELET PHYSICIAN SERVICES INC.

Active
Parent organization
CARONDELET HEALTH
Organization subpart
Yes

Provider details

NPI number
Legal business name
CARONDELET HEALTH
Authorized official
MR. STEVEN R CLEARY (CFO)
(816) 943-2819
Entity
Organization

Contact information

Practice address
220 NW RD MIZE RD, SUITE 101, BLUE SPRINGS, MO 64014-2527
(816) 228-9841
(816) 228-1514
Mailing address
801 NW SAINT MARY DR, SUITE 230, BLUE SPRINGS, MO 64014-2524
(816) 655-5792
(816) 655-5787

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0431315
KS
207R00000X
Internal Medicine Physician
Primary
35929
MO
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
2006003132
MO
207RP1001X
Pulmonary Disease Physician
R8H50
MO
207V00000X
Obstetrics & Gynecology Physician
2004006974
MO
207X00000X
Orthopaedic Surgery Physician
100628
MO
2084N0400X
Neurology Physician
2010008119
MO
208600000X
Surgery Physician
R4B19
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200640420A
KS
01
39532013
BLUE CROSS BLUE SHIELD
05
501269500
MO
Enumeration date
11/16/2007
Last updated
05/06/2011
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