Healthcare Provider Details

I. General information

NPI: 1376072751
Provider Name (Legal Business Name): ANDREW WESTBROOK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 11/08/2021
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 E CRAWFORD ST
SALINA KS
67401-5103
US

IV. Provider business mailing address

737 E CRAWFORD ST
SALINA KS
67401-5103
US

V. Phone/Fax

Practice location:
  • Phone: 785-827-7261
  • Fax: 785-833-5702
Mailing address:
  • Phone: 785-827-7261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number94-09187
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number05-43409
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: