| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 223 Maple St, Overbrook, Kansas |
| Authorized Official Name and Position | Kim Genelle Davis (ARNP FAMILY PRACTICE) |
| Authorized Official Contact | 7856653055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 327 223 Maple St Overbrook KS 66524 Ph: (785) 665-3055 | 223 Maple St Overbrook KS 66524 Ph: (785) 665-3055 |
| NPI Number | 1932164050 |
|---|---|
| Provider Enumeration Date | 04/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932164050 | NPI | - | NPPES |
| 6723 | Other | PHC | |
| 160997 | Other | BCBS CLINIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |