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General NPI Number Information
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NPI Number | 1013966902
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Entity Type | Organization
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Legal Business Name | SALINA PEDIATRIC CARE, LLC
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 520 S SANTA FE AVE STE. 120
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City | SALINA
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State | KS
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Zip | 67401-4190
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Country | US
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Telephone | 785-822-0397
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Fax |
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Provider Business Mailing Address
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Address Line | 533 SUNSET DR
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City | SALINA
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State | KS
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Zip | 67401-5442
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Country | US
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Telephone | 785-452-1768
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | GINGER CAUBLE SENSEMAN
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Credential | M.D.
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Telephone | 785-452-1768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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