Jesuit Lane Family Practice | |
907a E Jesuit Ln St Marys KS 66536-9605 | |
(785) 437-3711 | |
(785) 437-6711 |
Full Name | Jesuit Lane Family Practice |
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Speciality | Family Medicine |
Location | 907a E Jesuit Ln, St Marys, Kansas |
Authorized Official Name and Position | Carl Bruce Carroll (PHYSICIAN) |
Authorized Official Contact | 7854373711 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jesuit Lane Family Practice 907a E Jesuit Ln St Marys KS 66536-9605 Ph: (785) 437-3711 | Jesuit Lane Family Practice 907a E Jesuit Ln St Marys KS 66536-9605 Ph: (785) 437-3711 |
NPI Number | 1205802279 |
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Provider Enumeration Date | 02/28/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1205802279 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 04-23089 (Kansas) | Primary |
St Marys Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 206 Grand Ave, St Marys, KS 66536 Phone: 785-437-3734 Fax: 785-437-6186 |