Organization
CENTRAL CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE EVANS (CREDENTIALING)
(620) 603-8846
Entity
Organization
Contact information
Practice address
112 W ROSS BLVD, SUITE D, DODGE CITY, KS 67801-7219
(620) 371-7200
(888) 235-4591
Mailing address
PO BOX 256, SALINA, KS 67402-0256
(785) 823-0633
(844) 854-4662
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207RX0202X
Medical Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100143020C
—
KS
05
—
200480600C
—
OK
Enumeration date
04/03/2014
Last updated
04/02/2024
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