Organization
CUSHING HOSPITAL PHYSICIAN SERVICES L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SALLY BORDER (CHIEF FINANCIAL OFFICER)
(913) 684-1106
Entity
Organization
Contact information
Practice address
711 MARSHALL ST, LEAVENWORTH, KS 66048-3235
(913) 684-1100
(913) 684-1239
Mailing address
PO BOX 504954, SAINT LOUIS, MO 63150-4954
(913) 234-1350
(913) 234-1108
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000111423
BCBS
KS
05
—
1194906644
—
MO
05
—
200546030A
—
KS
Enumeration date
11/26/2007
Last updated
08/09/2010
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