Healthcare Provider Details

I. General information

NPI: 1477598837
Provider Name (Legal Business Name): OTTAWA FAMILY PHYSICIANS, CHARTERED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 10/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1418 S MAIN ST SUITE 5
OTTAWA KS
66067-3543
US

IV. Provider business mailing address

1418 S MAIN ST SUITE 5
OTTAWA KS
66067-3543
US

V. Phone/Fax

Practice location:
  • Phone: 785-242-1620
  • Fax: 785-242-3825
Mailing address:
  • Phone: 785-242-1620
  • Fax: 785-242-3825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DENNIS PHILLIP SPRATT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 785-242-1620