# SUSAN B. ALLEN MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SBA Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124594957
- **Authorized official:** MELISSA HALL (CEO)
- **Authorized official phone:** (316) 322-4558

## Contact information

- **Practice address:** 700 W CENTRAL AVE STE 103, EL DORADO, KS 67042-2187
- **Practice address phone:** (316) 321-8751
- **Practice address fax:** (316) 321-8752
- **Mailing address:** 720 W CENTRAL AVE, EL DORADO, KS 67042-2112
- **Mailing address phone:** (316) 321-3300
- **Mailing address fax:** (316) 321-4810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/19/2018
- **Last updated:** 05/16/2024