# BELOIT MEDICAL CENTER, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134176704
- **Authorized official:** DR. CRAIG ALAN CONCANNON M.D. (SECRETARY/TREASURER)
- **Authorized official phone:** (785) 738-2246

## Contact information

- **Practice address:** 1005 N LINCOLN AVE, BELOIT, KS 67420-1215
- **Practice address phone:** (785) 738-2246
- **Practice address fax:** (785) 738-4303
- **Mailing address:** PO BOX 587, BELOIT, KS 67420-0587
- **Mailing address phone:** (785) 738-2246

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 05/28/2006
- **Last updated:** 07/27/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 003910 | KS. BLUE SHIELD | KS |
| 05 | — | 100088300A | — | KS |