Healthcare Provider Details
I. General information
NPI: 1629150883
Provider Name (Legal Business Name): ASSOCIATES IN FAMILY HEALTH CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2006
Last Update Date: 05/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
712 1ST TER
LANSING KS
66043-1704
US
IV. Provider business mailing address
712 1ST TER
LANSING KS
66043-1704
US
V. Phone/Fax
- Phone: 913-727-6000
- Fax: 913-351-1346
- Phone: 913-727-6000
- Fax: 913-351-1346
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAIME
SUE
BURCH
Title or Position: CLINIC DIRECTOR
Credential:
Phone: 913-727-6000