Organization
RENOVO MEDICAL LLC
Active
Other names
University Medical
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. JOEL T ERSKIN SCD PA-C (CEO/PHYSICIAN ASSISTANT)
(620) 805-5162
Entity
Organization
Contact information
Practice address
816 N CAMPUS DR, SUITE 500, GARDEN CITY, KS 67846-6329
(620) 805-5162
(620) 805-5183
Mailing address
816 N CAMPUS DR, SUITE 500, GARDEN CITY, KS 67846-6329
(620) 805-5162
(620) 805-5183
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
0416265
KS
208D00000X
General Practice Physician
Primary
KS0434389
KS
363AS0400X
Surgical Physician Assistant
1500265
KS
363LF0000X
Family Nurse Practitioner
45404
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055515
BCBS
—
01
—
1487634069
NPI JOEL T. ERSKIN PA-C
KS
01
—
1669659967
NPI KRISTI L. SCHMITT
KS
01
—
1730135500
NPI
KS
05
—
200063310F
—
KS
01
—
659930
FIRST GUARD
—
Enumeration date
09/24/2008
Last updated
03/05/2016
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