| Northridge Family Medicine | |
|
15270 W 119th St Olathe KS 66062-5604 | |
| (913) 254-0828 | |
| Not Available |
| Full Name | Northridge Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 15270 W 119th St, Olathe, Kansas |
| Authorized Official Name and Position | Ken Washington (VP) |
| Authorized Official Contact | 9132540918 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northridge Family Medicine 15270 W 119th St Olathe KS 66062-5604 Ph: (913) 254-0828 | Northridge Family Medicine 15270 W 119th St Olathe KS 66062-5604 Ph: (913) 254-0828 |
| NPI Number | 1477596484 |
|---|---|
| Provider Enumeration Date | 06/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477596484 | NPI | - | NPPES |
| 20-877559-01 | Medicaid | KS | |
| 11372027 | Other | MO | BLUE COSS/BLUE SHIELD OF |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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