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11200 Lariat Way Dodge City KS 67801-7328 | |
| (620) 271-7400 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 11200 Lariat Way, Dodge City, Kansas |
| Authorized Official Name and Position | Julie K Wright (CEO) |
| Authorized Official Contact | 6202717400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
712 Saint John St Garden City KS 67846-5128 Ph: (620) 271-7400 | 11200 Lariat Way Dodge City KS 67801-7328 Ph: (620) 271-7400 |
| NPI Number | 1871973586 |
|---|---|
| Provider Enumeration Date | 06/08/2015 |
| Last Update Date | 06/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871973586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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