Organization
WESTPORT ANESTHESIA SERVICES OF MISSOURI, PC
Active
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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