Organization
LAWSON FAMILY PRACTICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIDNEY ALLEN RHEA CANTRELL D.O. (PRESIDENT)
(816) 580-4081
Entity
Organization
Contact information
Practice address
411 N PENNSYLVANIA AVE, LAWSON, MO 64062-9402
(816) 580-4081
(816) 580-0013
Mailing address
PO BOX 484, 411 N PENNSYLVANIA AVE, LAWSON, MO 64062-0484
(816) 580-4081
(816) 580-0013
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R9D24
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BLUE CROSS KC
33017015
MO
01
—
DG0442
MEDICARE RAILROAD GROUP
MO
Enumeration date
05/27/2006
Last updated
11/27/2007
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