Healthcare Provider Details

I. General information

NPI: 1366541955
Provider Name (Legal Business Name): EUGENE R VOTH RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 E 1ST ST
NEWTON KS
67114-5010
US

IV. Provider business mailing address

1506 HILLCREST RD
NEWTON KS
67114-1341
US

V. Phone/Fax

Practice location:
  • Phone: 316-283-2400
  • Fax: 316-284-6490
Mailing address:
  • Phone: 316-284-2506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number13-40746-031
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: