| Richard Douglas Iliff Md Pa | |
|
1119 Sw Gage Blvd Topeka KS 66604-1999 | |
| (785) 271-6161 | |
| (785) 271-6414 |
| Full Name | Richard Douglas Iliff Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1119 Sw Gage Blvd, Topeka, Kansas |
| Authorized Official Name and Position | Richard Douglas Iliff (PRESIDENT) |
| Authorized Official Contact | 7852716161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Douglas Iliff Md Pa 1119 Sw Gage Blvd Topeka KS 66604-1999 Ph: (785) 271-6161 | Richard Douglas Iliff Md Pa 1119 Sw Gage Blvd Topeka KS 66604-1999 Ph: (785) 271-6161 |
| NPI Number | 1306985064 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 07/30/2019 |
| Medicare PECOS PAC ID | 5294061271 |
|---|---|
| Medicare Enrollment ID | O20190729003137 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306985064 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | KS0418610 (Kansas) | Secondary |
| 207Q00000X | Family Medicine | KS1500243 (Kansas) | Primary |
| Provider Name | Richard Douglas Iliff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184692386 PECOS PAC ID: 5092874362 Enrollment ID: I20081103000082 |
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