Organization
DR JAMES GARDNER INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES DIXON GARDNER M.D. (CEO)
(785) 537-4940
Entity
Organization
Contact information
Practice address
1133 COLLEGE AVE, SUITE D200, MANHATTAN, KS 66502-2770
(785) 537-4940
(785) 537-0836
Mailing address
1133 COLLEGE AVE, SUITE D200, MANHATTAN, KS 66502-2770
(785) 537-4940
(785) 537-0836
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0416479
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497718092
PHYSICIAN NPI NUMBER
KS
01
—
480839957
OLD TAX ID FROM OLD PRACTICE ENDED 12/31/2014
KS
Enumeration date
12/20/2014
Last updated
12/20/2014
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