Organization
COUNTY OF STANTON
Active
Other names
Stanton County Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL WILKERSON (OFFICE MANAGER)
(620) 492-1400
Entity
Organization
Contact information
Practice address
114 N MAIN ST, JOHNSON, KS 67855-0639
(620) 492-1400
(620) 492-1608
Mailing address
114 N MAIN ST, BOX 639, JOHNSON, KS 67855-0639
(620) 492-1400
(620) 492-1608
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110737
BC
KS
Enumeration date
03/28/2006
Last updated
02/18/2010
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