Desoto Family Practice, Llc | |
33490 Lexington Ave De Soto KS 66018-8269 | |
(913) 583-1179 | |
Not Available |
Full Name | Desoto Family Practice, Llc |
---|---|
Speciality | Family Medicine |
Location | 33490 Lexington Ave, De Soto, Kansas |
Authorized Official Name and Position | Ken Washington (VP) |
Authorized Official Contact | 9135831179 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Desoto Family Practice, Llc 33490 Lexington Ave De Soto KS 66018-8269 Ph: (913) 583-1179 | Desoto Family Practice, Llc 33490 Lexington Ave De Soto KS 66018-8269 Ph: (913) 583-1179 |
NPI Number | 1407891732 |
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Provider Enumeration Date | 06/19/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407891732 | NPI | - | NPPES |
17436020 | Other | KS | BCBS OF KANSAS |
20-877756-01 | Medicaid | KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
News Archive
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