# SUSAN B. ALLEN MEMORIAL HOSPITAL

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

## Provider details

- **NPI number:** 1164554820
- **Authorized official:** MELISSA HALL (CEO)
- **Authorized official phone:** (316) 322-4558

## Contact information

- **Practice address:** 720 W CENTRAL AVE, EL DORADO, KS 67042-2112
- **Practice address phone:** (316) 321-3300
- **Practice address fax:** (316) 321-2916
- **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 |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/09/2007
- **Last updated:** 05/16/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 014081 | BCBS PART B | KS |
| 05 | — | 100002970E | — | KS |