| Total Wound Care Llc | |
|
7900 College Blvd Ste 143 Overland Park KS 66210-2194 | |
| (913) 286-4448 | |
| Not Available |
| Full Name | Total Wound Care Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 7900 College Blvd Ste 143, Overland Park, Kansas |
| Authorized Official Name and Position | Gary Hollingsworth (MANAGING DIRECTOR) |
| Authorized Official Contact | 8173602008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Wound Care Llc 250 Miron Dr Ste 120 Southlake TX 76092-7853 Ph: () - | Total Wound Care Llc 7900 College Blvd Ste 143 Overland Park KS 66210-2194 Ph: (913) 286-4448 |
| NPI Number | 1215782834 |
|---|---|
| Provider Enumeration Date | 04/18/2024 |
| Last Update Date | 05/21/2024 |
| Medicare PECOS PAC ID | 5991247843 |
|---|---|
| Medicare Enrollment ID | O20240606001147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215782834 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Jessica Croft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063064152 PECOS PAC ID: 7810225760 Enrollment ID: I20190829004069 |
| Provider Name | Deborah Thomson-diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851926638 PECOS PAC ID: 9739536921 Enrollment ID: I20240606002002 |
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