MEDICARE: HOSPITAL DISTRICT #1 OF CRAWFORD COUNTY

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528376035
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITAL DISTRICT #1 OF CRAWFORD COUNTY

Provider Business Mailing Address
First Line	:	302 N HOSPITAL DR
Second Line	:
City	:	GIRARD
State	:	KS
Zip	:	66743-2000
Country	:	US
Telephone Number	:	620-724-8291
Fax Number	:	620-724-6332

Provider Business Practice Location Address
First Line	:	307 N HOSPITAL DR
Second Line	:	SUITE 5
City	:	GIRARD
State	:	KS
Zip	:	66743-2014
Country	:	US
Telephone Number	:	620-724-8291
Fax Number	:	620-724-6332

Authorized Official
Title or Position	:	CEO
Name	:	KENNETH D BOYD JR.
Credential	:
Telephone Number	:	620-724-8281

Provider Enumeration Date	:	09/17/2010
Last Update Date	:	09/17/2010

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