| Jacqueline S Orender Do Llc | |
|
2305 S. Tucker Terrace Pittsburg KS 66762-6623 | |
| (620) 231-3132 | |
| (620) 231-3133 |
| Full Name | Jacqueline S Orender Do Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2305 S. Tucker Terrace, Pittsburg, Kansas |
| Authorized Official Name and Position | Jacqueline S Orender (OWNER/PHYSICIAN) |
| Authorized Official Contact | 6202313132 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline S Orender Do Llc 2305 S. Tucker Terrace Pittsburg KS 66762-2026 Ph: (620) 231-3132 | Jacqueline S Orender Do Llc 2305 S. Tucker Terrace Pittsburg KS 66762-6623 Ph: (620) 231-3132 |
| NPI Number | 1184955023 |
|---|---|
| Provider Enumeration Date | 01/15/2010 |
| Last Update Date | 02/22/2011 |
| Medicare PECOS PAC ID | 7012052657 |
|---|---|
| Medicare Enrollment ID | O20100306000170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184955023 | NPI | - | NPPES |
| 0529686 | Other | KS | KANSAS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0529686 (Kansas) | Primary |
| Provider Name | Jacqueline S Orender |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174559520 PECOS PAC ID: 9335157213 Enrollment ID: I20060404000521 |
| Provider Name | Lauren E Mendicki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275098873 PECOS PAC ID: 6901134394 Enrollment ID: I20220909000619 |
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