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311 E Main St Independence KS 67301-3713 | |
(620) 331-0601 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 311 E Main St, Independence, Kansas |
Authorized Official Name and Position | Gary M Johnson (CHIEF EXECUTIVE) |
Authorized Official Contact | 6203310601 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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311 E Main St Independence KS 67301-3713 Ph: (620) 331-0601 | 311 E Main St Independence KS 67301-3713 Ph: (620) 331-0601 |
NPI Number | 1154553006 |
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Provider Enumeration Date | 08/11/2009 |
Last Update Date | 08/11/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154553006 | NPI | - | NPPES |
005464 | Other | KS | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | C-3510 (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 | |