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General NPI Number Information
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NPI Number | 1376546085
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Entity Type | Organization
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Legal Business Name | CLAY CENTER FAMILY PHYSICIANS PA
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 815 CAMPBELL AVE
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City | CLYDE
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State | KS
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Zip | 66938-9428
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Country | US
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Telephone | 785-446-2226
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Fax |
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Provider Business Mailing Address
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Address Line | 609 LIBERTY ST
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City | CLAY CENTER
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State | KS
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Zip | 67432-1564
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Country | US
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Telephone | 785-632-2181
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Fax | 785-632-2309
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Authorized Official
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Title or Position | ADMINISTRATIVE SUPERVISOR
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Name | ROXANNE SCHOTTEL
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Credential |
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Telephone | 785-632-2181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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