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NPI Code Detail

MEDICARE: INZERILLO FAMILY PRACTICE, LLC

MEDICARE: INZERILLO FAMILY PRACTICE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0516222KS

General Provider Information

NPI Number : 1750498689
Entity Type Code : Organization
Provider Name (Legal Business Name) : INZERILLO FAMILY PRACTICE, LLC
Provider Business Mailing Address
First Line : 3320 CLINTON PARKWAY CT
Second Line : SUITE 100
City : LAWRENCE
State : KS
Zip : 66047-2629
Country : US
Telephone Number : 785-749-0333
Fax Number : 785-749-4559
Provider Business Practice Location Address
First Line : 3320 CLINTON PARKWAY CT
Second Line : SUITE 100
City : LAWRENCE
State : KS
Zip : 66047-2629
Country : US
Telephone Number : 785-749-0333
Fax Number : 785-749-4559
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. MARY FRANCIS INZERILLO
Credential :
Telephone Number : 785-749-0333
Provider Enumeration Date : 08/24/2006
Last Update Date : 08/22/2020

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Directions to “INZERILLO FAMILY PRACTICE, LLC ” Practice Location

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