MEDICARE: EMPORIA FAMILY MEDICINE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110953	OTHER	KS	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326067539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPORIA FAMILY MEDICINE, LLC

Provider Business Mailing Address
First Line	:	1301 W 12TH AVE
Second Line	:	SUITE 301
City	:	EMPORIA
State	:	KS
Zip	:	66801-2587
Country	:	US
Telephone Number	:	620-343-2376
Fax Number	:	620-343-0095

Provider Business Practice Location Address
First Line	:	1301 W 12TH AVE
Second Line	:	SUITE 301
City	:	EMPORIA
State	:	KS
Zip	:	66801-2587
Country	:	US
Telephone Number	:	620-343-2376
Fax Number	:	620-343-0095

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KENDALL M. WRIGHT
Credential	:	M.D.
Telephone Number	:	620-343-2376

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	12/18/2009

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Directions to “EMPORIA FAMILY MEDICINE, LLC ” Practice Location

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