Organization
WESTPORT ANESTHESIA SERVICES OF MISSOURI, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH DYER (COO)
(816) 389-6030
Entity
Organization
Contact information
Practice address
4401 WORNALL RD, ANESTHESIA DEPT, KANSAS CITY, MO 64111-3220
(816) 389-6030
(816) 389-6034
Mailing address
9233 WARD PKWY, SUITE 230, KANSAS CITY, MO 64114-3366
(816) 389-6030
(816) 389-6034
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027105
BCBS-KS GROUP NUMBER
MO
01
—
04107016
MO BCBS GROUP NUMBER
MO
01
—
900018
MO FHP GROUP NUMBER
MO
01
—
CI4728
RR MEDICARE
MO
Enumeration date
05/17/2006
Last updated
02/12/2008
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