| Organization Name: | C&S MEDICAL CLINIC PA |
| NPI Number: | 1265487359 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRIS SANDOVAL (OFFICE MANAGER) |
| Mailing Address: | 2200 Summerlon Circle Suite A Dodge City |
| State: | KS US |
| Postal Code: | 678012905 |
| Phone Number: | 6204089700 |
| Fax Number: | 6204089701 |
| NPI Enumeration Date: | 05/24/2006 |
| NPI Last Update Date: | 02/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |