Organization
LIBERTY MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIANNE MERIDETH (BILLING)
(816) 415-2233
Entity
Organization
Contact information
Practice address
1504 NE 96TH ST STE A, LIBERTY, MO 64068-1351
(816) 415-2233
(816) 415-2218
Mailing address
1504 NE 96TH ST STE A, LIBERTY, MO 64068-1351
(816) 415-2233
(816) 415-2218
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2000146367
MO
261QP2300X
Primary Care Clinic/Center
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205388101
—
MO
01
—
40035011
BCBS
MO
Enumeration date
06/12/2007
Last updated
03/20/2026
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