Healthcare Provider Details

I. General information

NPI: 1912302175
Provider Name (Legal Business Name): MANHATTAN GYNECOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2014
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 AMHERST AVE SUITE B
MANHATTAN KS
66503-3043
US

IV. Provider business mailing address

2900 AMHERST AVE SUITE B
MANHATTAN KS
66503-3043
US

V. Phone/Fax

Practice location:
  • Phone: 316-708-2846
  • Fax:
Mailing address:
  • Phone: 316-708-2846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberKS0434347
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. KATIE SUTTON
Title or Position: OWNER
Credential: M.D.
Phone: 316-708-2846