St Joseph Specialty Clinic PC

NPI #1962424895 in Bethany, Missouri

Provider Information

NPI Number: 1962424895
Entity Type: Organization
Organization Name: St Joseph Specialty Clinic PC
Primary Specialty: Surgery
Enumeration Date: Jul 23, 2006
Last Updated: Jan 4, 2023

Practice Location

Address: 2600 MILLER ST
City: Bethany
State: Missouri
ZIP Code: 64424-2701
Phone: (660) 425-0253

Authorized Official

Name: KENNETH W SHEWELL, MD
Title: SECRETARY
Phone: (816) 866-5105

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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