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General NPI Number Information
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NPI Number | 1578412979
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Entity Type | Organization
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Legal Business Name | I360MD, LLC
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 705 HIGH ST
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City | BALDWIN CITY
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State | KS
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Zip | 66006-3015
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Country | US
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Telephone | 913-430-1751
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Fax | 913-490-1592
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Provider Business Mailing Address
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Address Line | 37000 W 155TH ST
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City | GARDNER
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State | KS
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Zip | 66030-9617
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Country | US
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Telephone | 913-430-1751
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Fax | 913-490-1592
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Authorized Official
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Title or Position | FAMILY PHYSICIAN
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Name | PAIGE E BOWMAN
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Credential | MD
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Telephone | 970-390-3046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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