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General NPI Number Information
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NPI Number | 1285681577
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Entity Type | Organization
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Legal Business Name | PANACEA FAMILY MEDICINE, PA
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 03/06/2013
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Provider Practice Location Address
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Address Line | 629 S PLUMMER AVE
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City | CHANUTE
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State | KS
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Zip | 66720-1928
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Country | US
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Telephone | 620-432-5588
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Fax | 620-432-5593
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Provider Business Mailing Address
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Address Line | PO BOX 843
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City | CHANUTE
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State | KS
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Zip | 66720-0843
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Country | US
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Telephone | 620-432-5588
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Fax | 620-432-5593
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Authorized Official
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Title or Position | OWNER
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Name | VERDON W PARHAM
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Credential | M.D.
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Telephone | 620-432-5588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | KS
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