Provider Demographics
NPI:1295284933
Name:PLATTE COUNTY PEDIATRICS
Entity type:Organization
Organization Name:PLATTE COUNTY PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOWRY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:816-858-5253
Mailing Address - Street 1:1104 PLATTE FALLS RD
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-7629
Mailing Address - Country:US
Mailing Address - Phone:816-858-5253
Mailing Address - Fax:816-858-5205
Practice Address - Street 1:1104 PLATTE FALLS RD
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079-7629
Practice Address - Country:US
Practice Address - Phone:816-858-5253
Practice Address - Fax:816-858-5205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty