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General NPI Number Information
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NPI Number | 1790295210
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Entity Type | Organization
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Legal Business Name | FAMILYMED PA
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 22450 S HARRISON ST STE 100
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City | SPRING HILL
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State | KS
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Zip | 66083-8882
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Country | US
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Telephone | 913-527-2720
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Fax |
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Provider Business Mailing Address
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Address Line | 22450 S HARRISON ST STE 100
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City | SPRING HILL
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State | KS
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Zip | 66083-8882
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Country | US
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Telephone | 913-527-2720
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ALI SEELING
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Credential | RN
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Telephone | 913-527-2720
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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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