1679529754 NPI number — MIDWEST UROLOGY & RADIATION ONCOLOGY, INC, PC.

Table of content: REBECCA MARIE SEITZ MSW, LCSW (NPI 1922446343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679529754 NPI number — MIDWEST UROLOGY & RADIATION ONCOLOGY, INC, PC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIDWEST UROLOGY & RADIATION ONCOLOGY, INC, PC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679529754
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/26/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17525 MEDICAL CENTER PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDEPENDENCE
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64057-1824
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-836-6875
Provider Business Mailing Address Fax Number:
816-214-9009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19001 E 48TH ST S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDEPENDENCE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64055-6964
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-836-8831
Provider Business Practice Location Address Fax Number:
816-795-0144
Provider Enumeration Date:
05/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DICKENS
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
816-836-6875

Provider Taxonomy Codes

  • Taxonomy code: 208800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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