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Organization

DR. J.A. DIRENNA JR, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES A DIRENNA JR. DO (DIRECTOR)
(816) 225-1643
Entity
Organization

Contact information

Practice address
1 THE WOODLANDS, GLADSTONE, MO 64119-1853
(816) 225-1643
(913) 248-9383
Mailing address
PO BOX 2181, INDEPENDENCE, MO 64055-0081
(913) 248-9693
(913) 248-9383

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R6C32
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19739014
BLUE SHIELD KC
MO
Enumeration date
02/13/2007
Last updated
08/22/2020
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