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510 Peter Pan Rd Ste B Independence KS 67301-7300 | |
(620) 577-4310 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 510 Peter Pan Rd Ste B, Independence, Kansas |
Authorized Official Name and Position | Thomas L Macaronas (CFO/COO) |
Authorized Official Contact | 6208205251 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 736 Parsons KS 67357 Ph: (620) 577-4310 | 510 Peter Pan Rd Ste B Independence KS 67301-7300 Ph: (620) 577-4310 |
NPI Number | 1154787190 |
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Provider Enumeration Date | 01/06/2016 |
Last Update Date | 09/21/2023 |
Medicare PECOS PAC ID | 5496664369 |
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Medicare Enrollment ID | O20160127002110 |
Identifier | Type | State | Issuer |
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1154787190 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | 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 | |