| |
1402 S Main St, Ottawa, KS 66067-3529 | |
(785) 893-0494 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Podiatrist |
Location | 1402 S Main St, Ottawa, Kansas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417453168 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 12-00358 (Kansas) | Primary |
Mailing Address | Practice Location Address |
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230 E Main St Ste C, Gardner, KS 66030-1643 Ph: (913) 856-8150 | 1402 S Main St, Ottawa, KS 66067-3529 Ph: (785) 893-0494 |
Sukhantar Dhepyasuvarn, D.P.M. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 116 S Main St, Suite A, Ottawa, KS 66067 Phone: 785-242-3310 |