Organization
COCKERELL & MCINTOSH PEDIATRIC URGENT CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN E WOOD (GENERAL MANAGER)
(816) 228-4770
Entity
Organization
Contact information
Practice address
11200 E WINNER RD, INDEPENDENCE, MO 64052-3964
(816) 252-9850
Mailing address
205 NW R D MIZE RD, SUITE 304, BLUE SPRINGS, MO 64014
(816) 228-4770
(816) 228-1156
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202402
FAMILY HEALTH PARTNERS ID
MO
01
—
377880
FIRST GUARD ID
MO
01
—
4430403
AETNA PROVIDER ID
MO
01
—
6606969
UNITED HEALTHCARE ID
MO
Enumeration date
07/05/2006
Last updated
01/31/2011
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