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111 W Spring Ave Conway Springs KS 67031-3100 | |
(620) 456-2411 | |
(620) 456-2495 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 111 W Spring Ave, Conway Springs, Kansas |
Authorized Official Name and Position | Bill Widener (CEO) |
Authorized Official Contact | 6208967324 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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700 W 13th St Harper KS 67058-1401 Ph: (620) 896-7324 | 111 W Spring Ave Conway Springs KS 67031-3100 Ph: (620) 456-2411 |
NPI Number | 1811174121 |
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Provider Enumeration Date | 01/29/2008 |
Last Update Date | 04/09/2015 |
Identifier | Type | State | Issuer |
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1811174121 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | H039003 (Kansas) | Primary |