Organization
MIDTOWN FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN DIEBOLD (OFFICE MANAGER)
(816) 756-5839
Entity
Organization
Contact information
Practice address
3406 BROADWAY BLVD STE B, KANSAS CITY, MO 64111-2767
(816) 756-5839
(816) 756-5874
Mailing address
3406 BROADWAY BLVD STE B, KANSAS CITY, MO 64111-2767
(816) 756-5839
(816) 756-5874
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36683
MO
Other
Enumeration date
03/13/2009
Last updated
04/14/2021
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