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900 W Myrtle St Suite 105 Independence KS 67301-3242 | |
(620) 331-8190 | |
(620) 652-4143 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 900 W Myrtle St, Independence, Kansas |
Authorized Official Name and Position | Susan V.m. Kleinbeck (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6203318190 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 612 Independence KS 67301-0612 Ph: (620) 331-8190 | 900 W Myrtle St Suite 105 Independence KS 67301-3242 Ph: (620) 331-8190 |
NPI Number | 1285896993 |
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Provider Enumeration Date | 06/25/2008 |
Last Update Date | 06/25/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285896993 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | NONE REQUIRED (Kansas) | Primary |
Robert M Osborn Do Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 N. 14th St., Independence, KS 67301 Phone: 620-331-2070 | |