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NPI Code Detail

MEDICARE: JEAN PRINGLE M.D.

MEDICARE: JEAN PRINGLE M.D.
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
1207R00000XInternal Medicine Physician04-25732KS

General Provider Information

NPI Number : 1912957580
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN PRINGLE M.D.
Provider Business Mailing Address
First Line : 1905 19TH ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-2502
Country : US
Telephone Number : 620-792-5700
Fax Number : 855-463-0851
Provider Business Practice Location Address
First Line : 1905 19TH ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-2502
Country : US
Telephone Number : 620-792-5700
Fax Number : 855-463-0851
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 04/15/2026

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