Organization Name: | FAMILY MEDCENTERS, P.A. |
NPI Number: | 1114025137 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID WAYNE NIEDEREE (PRESIDENT) |
Mailing Address: | 1101 N Rock Rd Derby |
State: | KS US |
Postal Code: | 670373735 |
Phone Number: | 3167886963 |
Fax Number: | 3167895373 |
NPI Enumeration Date: | 09/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | S-087-011 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |