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NPI Code Detail

MEDICARE: WESTERN PLAINS PHYSICIAN PRACTICES LLC

MEDICARE: WESTERN PLAINS PHYSICIAN PRACTICES 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
1208600000XSurgery Physician0432750KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770616252
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTERN PLAINS PHYSICIAN PRACTICES LLC
Provider Business Mailing Address
First Line : 112 W ROSS BLVD
Second Line : SUITE C
City : DODGE CITY
State : KS
Zip : 67801-7219
Country : US
Telephone Number : 620-227-5334
Fax Number : 620-227-5212
Provider Business Practice Location Address
First Line : 112 W ROSS BLVD
Second Line : SUITE C
City : DODGE CITY
State : KS
Zip : 67801-7219
Country : US
Telephone Number : 620-227-5334
Fax Number : 620-227-5212
Authorized Official
Title or Position : DIVISION PRESIDENT
Name : MR. THOMAS M WEISS
Credential :
Telephone Number : 615-372-8500
Provider Enumeration Date : 03/13/2007
Last Update Date : 05/07/2009

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Directions to “WESTERN PLAINS PHYSICIAN PRACTICES LLC ” Practice Location

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