Healthcare Provider Details

I. General information

NPI: 1760455752
Provider Name (Legal Business Name): FAMILY PHYSICIANS OF KANSAS L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 N ANDOVER RD
ANDOVER KS
67002-9712
US

IV. Provider business mailing address

524 N ANDOVER RD
ANDOVER KS
67002-9712
US

V. Phone/Fax

Practice location:
  • Phone: 316-733-0716
  • Fax: 316-733-1240
Mailing address:
  • Phone: 316-733-0716
  • Fax: 316-733-1240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES M HARTLEY
Title or Position: PRESIDENT
Credential: MD
Phone: 316-733-0716