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2820 Ohio St Augusta KS 67010-2361 | |
(316) 775-7500 | |
(316) 775-3685 |
Full Name | |
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Speciality | Family Medicine |
Location | 2820 Ohio St, Augusta, Kansas |
Authorized Official Name and Position | Robin Kay Hoefgen (OFFICE MANAGER) |
Authorized Official Contact | 3167757500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2820 Ohio St Augusta KS 67010-2361 Ph: (316) 775-7500 | 2820 Ohio St Augusta KS 67010-2361 Ph: (316) 775-7500 |
NPI Number | 1891730339 |
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Provider Enumeration Date | 06/18/2006 |
Last Update Date | 12/11/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891730339 | NPI | - | NPPES |
3000443620001 | Medicaid | KS | |
102650 | Other | KS | IND PTAN |
17D1008887 | Other | KS | CLIA |
1700218914 | Other | KS | MIDLEVEL IND NPI |
1891730339 | Other | KS | GRP. NPI |
1932166154 | Other | KS | IND. NPI |
3000388587001 | Medicaid | KS | |
102644 | Other | KS | GRP PTAN |
1114372083 | Other | KS | MIDLEVEL IND. NPI |
1205272259 | Other | KS | MIDLEVEL IND NPI |
1902412117 | Other | KS | MIDLEVEL IND. NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 05-28837 (Kansas) | Primary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
Authentic Living Counseling Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7939 Sw 163rd St, Augusta, KS 67010 Phone: 360-899-8577 | |