OrganizationActive
Excelsior Springs Physicians Clinic
NPI 1629491105 · Adolescent Medicine (Family Medicine) Physician · Excelsior Springs, MO
Provider details
- NPI number
- 1629491105
- Entity type
- Organization
- Primary specialty
- Adolescent Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jennifer Boomgarden, Physicians Practice Manager(816) 629-2623
- License
- R6J43 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182
Phone: (816) 629-2623
Fax: (816) 629-2722
Approximate (ZIP-level) locationGet directions
Mailing address
1010 N Jesse James Rd
Excelsior Springs, MO 64024-1202
Registry dates
- Enumerated
- 2014-02-04
- Last updated
- 2014-02-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.