Provider Demographics
NPI:1285773655
Name:CRAIG I. SCHWARTZ, D.O., P.A.
Entity type:Organization
Organization Name:CRAIG I. SCHWARTZ, D.O., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:I
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO,FACOS,FICS,RPVI
Authorized Official - Phone:913-451-8346
Mailing Address - Street 1:1300 E 104TH ST STE 150
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4561
Mailing Address - Country:US
Mailing Address - Phone:913-451-8346
Mailing Address - Fax:913-451-8347
Practice Address - Street 1:1300 E 104TH ST STE 150
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-4561
Practice Address - Country:US
Practice Address - Phone:913-451-8346
Practice Address - Fax:913-451-8347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-301312086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSDB6536OtherRR MEDICARE
KSE78168Medicare UPIN