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240 W 18th St Horton KS 66439-1245 | |
(785) 486-2642 | |
(785) 486-2842 |
Full Name | |
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Speciality | Family Medicine |
Location | 240 W 18th St, Horton, Kansas |
Authorized Official Name and Position | Dale A. White (CEO) |
Authorized Official Contact | 7854862642 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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240 W 18th St Horton KS 66439-1245 Ph: (785) 486-2642 | 240 W 18th St Horton KS 66439-1245 Ph: (785) 486-2642 |
NPI Number | 1750325197 |
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Provider Enumeration Date | 06/16/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750325197 | NPI | - | NPPES |
426980 | Other | KS | BLUE SHIELD |
161636 | Other | KS | BLUE SHIELD |
426996 | Other | KS | BLUE SHIELD |
664990 | Other | KS | FIRST GUARD HEALTH PLAN |
927587 | Other | KS | FIRST GUARD HEALTH PLAN |
928432 | Other | KS | FIRST GUARD HEALTH PLAN |
105445 | Other | KS | BLUE SHIELD |
042154 | Other | KS | BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | H-007-002 (Kansas) | Primary |