Healthcare Provider Details

I. General information

NPI: 1407603277
Provider Name (Legal Business Name): MIAMI COUNTY MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 05/01/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 BAPTISTE DR
PAOLA KS
66071-1314
US

IV. Provider business mailing address

2100 BAPTISTE DR
PAOLA KS
66071-1314
US

V. Phone/Fax

Practice location:
  • Phone: 913-294-2327
  • Fax: 913-294-9897
Mailing address:
  • Phone: 913-294-2327
  • Fax: 913-294-9897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CATHY WIENS
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 913-791-4459