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General NPI Number Information
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NPI Number | 1629177316
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Entity Type | Organization
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Legal Business Name | QUINLAN EYE SURGERY & LASER CENTER, P.A.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 12/23/2009
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Provider Practice Location Address
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Address Line | 918 HIGHWAY 69
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City | FORT SCOTT
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State | KS
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Zip | 66701-8885
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Country | US
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Telephone | 620-223-0200
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Fax | 620-224-3029
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Provider Business Mailing Address
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Address Line | 918 HIGHWAY 69
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City | FORT SCOTT
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State | KS
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Zip | 66701-8885
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Country | US
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Telephone | 620-223-0200
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Fax | 620-224-3029
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. GREGORY H QUINLAN
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Credential | D.O.
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Telephone | 620-223-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | S006001
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License Number State | KS
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