Healthcare Provider Details

I. General information

NPI: 1376625749
Provider Name (Legal Business Name): MINNEOLA DISTRICT HOSPITAL NBR 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 SUMMERLON CIR STE A
DODGE CITY KS
67801-2905
US

IV. Provider business mailing address

PO BOX 127
MINNEOLA KS
67865-0127
US

V. Phone/Fax

Practice location:
  • Phone: 620-371-7300
  • Fax: 620-371-7304
Mailing address:
  • Phone: 620-885-4264
  • Fax: 620-885-4602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberH013002
License Number StateKS

VIII. Authorized Official

Name: DEBORAH BRUNER
Title or Position: CEO
Credential:
Phone: 620-885-4264