Organization
PHEASANT RIDGE FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSS KIMBALL MD (PHYSICIAN)
(785) 787-5050
Entity
Organization
Contact information
Practice address
312 S MAPLE ST, GARNETT, KS 66032-1333
(785) 787-5050
Mailing address
312 S MAPLE ST, GARNETT, KS 66032-1333
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/16/2019
Last updated
11/16/2019
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