Organization
COCKERELL & MCINTOSH PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN E WOOD (PRACTICE ADMINISTRATOR)
(816) 228-4770
Entity
Organization
Contact information
Practice address
205 NW R D MIZE RD, STE 304, BLUE SPRINGS, MO 64014-2515
(816) 228-4770
(816) 228-1156
Mailing address
205 NW R D MIZE RD, STE 304, BLUE SPRINGS, MO 64014-2515
(816) 228-4770
(816) 228-1156
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2016036885
MO
Other
Enumeration date
02/17/2017
Last updated
02/17/2017
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