Organization
PEDIATRIC ASSOCIATES OF MANHATTAN, P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY ANN TRUITT (OFFICE MANAGER)
(785) 537-9030
Entity
Organization
Contact information
Practice address
1133 COLLEGE AVE, SUITE G-210, MANHATTAN, KS 66502-2770
(785) 537-9030
(785) 537-3334
Mailing address
1133 COLLEGE AVE, SUITE G-210, MANHATTAN, KS 66502-2770
(785) 537-9030
(785) 537-3334
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000003920
BLUE SHIELD
KS
05
—
100087970A
—
KS
Enumeration date
10/06/2006
Last updated
03/18/2014
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