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1402 S Main St Ottawa KS 66067-3529 | |
| (785) 242-1707 | |
| (785) 242-1709 |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 1402 S Main St, Ottawa, Kansas |
| Authorized Official Name and Position | Amy C Miller (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7858400505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1402 S Main St Ottawa KS 66067-3529 Ph: (785) 242-1707 | 1402 S Main St Ottawa KS 66067-3529 Ph: (785) 242-1707 |
| NPI Number | 1174843254 |
|---|---|
| Provider Enumeration Date | 06/11/2010 |
| Last Update Date | 06/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174843254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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