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General NPI Number Information
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NPI Number | 1710292420
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Entity Type | Organization
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Legal Business Name | CLIFTON FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 03/30/2021
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Provider Practice Location Address
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Address Line | 201 S HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67211-2128
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Country | US
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Telephone | 316-682-6551
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Fax | 316-682-8151
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Provider Business Mailing Address
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Address Line | 201 S HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67211-2128
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Country | US
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Telephone | 316-682-6551
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Fax | 316-682-8151
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Authorized Official
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Title or Position | OWNER
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Name | JAMES ANDREW HILD
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Credential | DO
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Telephone | 316-682-6551
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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 | 05-31083
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License Number State | KS
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