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General NPI Number Information
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NPI Number | 1215459367
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Entity Type | Organization
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Legal Business Name | JEFFERSON COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 07/11/2017
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Last Update Date | 07/11/2017
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Provider Practice Location Address
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Address Line | 412 E WALNUT ST
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City | NORTONVILLE
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State | KS
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Zip | 66060-4008
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Country | US
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Telephone | 844-536-9449
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Fax | 844-415-1702
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Provider Business Mailing Address
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Address Line | 408 DELAWARE ST
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City | WINCHESTER
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State | KS
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Zip | 66097-4003
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Country | US
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Telephone | 844-536-9449
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Fax | 844-415-1702
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Authorized Official
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Title or Position | HIM DIRECTOR/CREDENTIALING AGENT
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Name | ELIZABETH FINLEY
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Credential |
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Telephone | 844-536-9449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 08-00268
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License Number State | KS
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