Fw Huston Medical Clinic | |
504 Plaza Dr Suite 300 Perry KS 66073-4136 | |
(913) 774-4340 | |
(913) 774-3379 |
Full Name | Fw Huston Medical Clinic |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 504 Plaza Dr, Perry, Kansas |
Authorized Official Name and Position | Lamont Cook (CEO) |
Authorized Official Contact | 9137744340 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Fw Huston Medical Clinic 408 Delaware St Winchester KS 66097-4003 Ph: (913) 774-4340 | Fw Huston Medical Clinic 504 Plaza Dr Suite 300 Perry KS 66073-4136 Ph: (913) 774-4340 |
NPI Number | 1447660360 |
---|---|
Provider Enumeration Date | 04/30/2014 |
Last Update Date | 06/23/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447660360 | NPI | - | NPPES |
110046 | Other | KS | MEDICARE ID-TYPE UNSPECIFIED |
100080370F | Medicaid | KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |