Organization
HARRISONVILLE FAMILY MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN HOLDEN M.D. (PRESIDENT)
(816) 380-3582
Entity
Organization
Contact information
Practice address
2820 E ROCK HAVEN RD, SUITE 100, HARRISONVILLE, MO 64701-4411
(816) 380-3582
(816) 380-6964
Mailing address
2820 E ROCK HAVEN RD, SUITE 100, HARRISONVILLE, MO 64701-4411
(816) 380-3582
(816) 380-6964
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24999018
BLUE CROSS BLUE SHIELD
—
05
—
504598905
—
MO
01
—
CS2185
RAILROAD MEDICARE
—
Enumeration date
07/21/2006
Last updated
01/13/2026
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