State Line Medical Group LLC
NPI #1679529853 in Kansas City, Missouri
Provider Information
- NPI Number
- 1679529853
- Entity Type
- Organization
- Organization Name
- State Line Medical Group LLC
- Primary Specialty
- Internal Medicine
- Enumeration Date
- May 26, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 7611 STATE LINE RD
- Address 2
- SUITE 103
- City
- Kansas City
- State
- Missouri
- ZIP Code
- 64114-6801
- Phone
- (816) 333-9886
Authorized Official
- Name
- KEN WASHINGTON
- Title
- VP
- Phone
- (816) 333-9886
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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