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General NPI Number Information
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NPI Number | 1588825046
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Entity Type | Organization
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Legal Business Name | DODGE CITY FAMILY PLANNING CLINIC
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 811 N 2ND AVE
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City | DODGE CITY
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State | KS
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Zip | 67801-4412
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Country | US
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Telephone | 620-225-1933
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Fax | 620-225-1933
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Provider Business Mailing Address
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Address Line | 811 N 2ND AVE
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City | DODGE CITY
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State | KS
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Zip | 67801-4412
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Country | US
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Telephone | 620-225-1933
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Fax | 620-225-1933
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Authorized Official
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Title or Position | CLINIC EXECUTIVE DIRECTOR
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Name | KARLA DEMUTH
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Credential | ARNP
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Telephone | 620-225-1933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number | 1100285
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License Number State | KS
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