| Organization Name: | ADVANTAGE MEDICAL GROUP LLC |
| NPI Number: | 1922060128 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DOUGLAS KNOX (MEDICAL DIRECTOR) |
| Mailing Address: | 1104 E 23rd St Lawrence |
| State: | KS US |
| Postal Code: | 660465004 |
| Phone Number: | 7857490130 |
| Fax Number: | 7857490132 |
| NPI Enumeration Date: | 04/04/2006 |
| NPI Last Update Date: | 11/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0428304 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |