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General NPI Number Information
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NPI Number | 1568912939
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Entity Type | Organization
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Legal Business Name | NEOSHO MEMORIAL REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 10/10/2016
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Last Update Date | 10/25/2024
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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 | 620-432-5700
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Fax | 620-432-5778
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Provider Business Mailing Address
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Address Line | PO BOX 426
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City | CHANUTE
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State | KS
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Zip | 66720-0426
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Country | US
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Telephone | 620-432-5700
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Fax | 620-432-5778
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Authorized Official
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Title or Position | CFO
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Name | LAUREN K TINSLEY
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Credential |
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Telephone | 620-431-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | H-067-001
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License Number State | KS
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