Organization
INDEPENDENCE PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACEY FARIBORZ LPN (OFFICE MANAGER)
(816) 373-1142
Entity
Organization
Contact information
Practice address
17500 MEDICAL CENTER PKWY, SUITE 5, INDEPENDENCE, MO 64057
(816) 373-1111
(816) 378-9222
Mailing address
17500 MEDICAL CENTER PKWY, SUITE 5, INDEPENDENCE, MO 64057
(816) 373-1111
(816) 378-9222
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33997011
BCBS
—
Enumeration date
06/05/2008
Last updated
06/05/2008
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