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Organization

JACKSON COUNTY MEDICAL GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICK J KUENY (VP)
(816) 350-0005
Entity
Organization

Contact information

Practice address
17221 E 23RD ST S, SUITE 100, INDEPENDENCE, MO 64057-1803
(816) 350-0005
Mailing address
17221 E 23RD ST S, SUITE 100, INDEPENDENCE, MO 64057-1803

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09139031
BCBS OF KANSAS
MO
Enumeration date
05/28/2006
Last updated
08/14/2007
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