Organization
STEPHENS ADVANCED WOUNDCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAD A. STEPHENS MD (PRESIDENT)
(913) 526-8813
Entity
Organization
Contact information
Practice address
10000 WORNALL RD, KANSAS CITY, MO 64114-4359
(816) 942-0994
Mailing address
10000 WORNALL RD, KANSAS CITY, MO 64114-4359
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
102147
MO
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
102147
MO
Other
Enumeration date
05/02/2012
Last updated
05/02/2012
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