Individual
DR. JOHN COOPER GOLLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1418 S MAIN ST, SUITE 5, OTTAWA, KS 66067-3543
(785) 242-1620
(785) 242-3825
Mailing address
1418 S MAIN ST, SUITE 5, OTTAWA, KS 66067-3543
(785) 242-1620
(785) 242-3825
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-28601
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058541
BLUE CROSS BLUE SHIELD KS
KS
01
—
26325027
BC/BS KANSAS CITY
KS
01
—
2924584001
CIGNA INDIVIDUAL NUMBER
KS
01
—
335891
HEALTHWAVE
KS
01
—
5818702
AETNA INDIVIDUAL NUMBER
KS
Enumeration date
07/06/2006
Last updated
07/09/2007
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