MEDICARE: THE FAMILY PHYSICIANS PA

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	261QR1300X	Rural Health Clinic/Center	178969	KS

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
2	1550	OTHER	KS	BLUE CROSS RHC
3	178969	OTHER	KS	RURAL HEALTH IDENTIFICATION
4	17D0450573	OTHER		CLIA WAIVER

General Provider Information

NPI Number	:	1851325773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE FAMILY PHYSICIANS PA

Provider Business Mailing Address
First Line	:	1408 EAST STREET
Second Line	:
City	:	IOLA
State	:	KS
Zip	:	66749-3004
Country	:	US
Telephone Number	:	620-365-3115
Fax Number	:	620-365-7717

Provider Business Practice Location Address
First Line	:	1408 EAST ST
Second Line	:
City	:	IOLA
State	:	KS
Zip	:	66749-4402
Country	:	US
Telephone Number	:	620-365-3115
Fax Number	:	620-365-7717

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARTHA ELAINE O'CONNOR
Credential	:
Telephone Number	:	620-365-3115

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	10/04/2024

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Directions to “THE FAMILY PHYSICIANS PA ” Practice Location

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