Healthcare Provider Details

I. General information

NPI: 1033052766
Provider Name (Legal Business Name): NEOSHO MEMORIAL REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S WASHINGTON AVE
IOLA KS
66749-3256
US

IV. Provider business mailing address

PO BOX 426
CHANUTE KS
66720-0426
US

V. Phone/Fax

Practice location:
  • Phone: 620-365-0151
  • Fax: 620-431-7556
Mailing address:
  • Phone: 620-432-5588
  • Fax:

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: WENDY BRAZIL
Title or Position: CEO
Credential:
Phone: 620-432-5310