Organization
SPINE SURGERY, LTD.
Active
Organization
SPINE SURGERY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID K EBELKE M.D. (PRESIDENT)
(816) 471-6611
Entity
Organization
Contact information
Practice address
2790 CLAY EDWARDS DR STE 630, NORTH KANSAS CITY, MO 64116
(816) 471-6611
(816) 471-6192
Mailing address
2790 CLAY EDWARDS DR STE 630, NORTH KANSAS CITY, MO 64116-3274
(816) 471-6611
(816) 471-6192
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
R5J93
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09-00147
UNITED HEALTHCARE
—
01
—
16215019
BCBS OF KC
—
01
—
200006715
RAILROAD MEDICARE
—
01
—
4498957
AETNA
—
01
—
552036
BCBS OF KS
—
Enumeration date
01/04/2007
Last updated
06/05/2018
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