# WESTERN JOHNSON COUNTY MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1467405035
- **Authorized official:** WENDY BLAYLOCK (OFFICE MANAGER)
- **Authorized official phone:** (816) 597-3500

## Contact information

- **Practice address:** 305 E PACIFIC ST, KINGSVILLE, MO 64061-2512
- **Practice address phone:** (816) 597-3500
- **Practice address fax:** (816) 597-3555
- **Mailing address:** PO BOX 111, KINGSVILLE, MO 64061-0111
- **Mailing address phone:** (816) 597-3500
- **Mailing address fax:** (816) 597-3555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 09/07/2007