Organization
CLAY COUNTY MEDICAL CENTER
Active
Parent organization
CLAY COUNTY MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLAY COUNTY MEDICAL CENTER
Authorized official
AUSTIN GILLARD (CEO)
(785) 632-2144
Entity
Organization
Contact information
Practice address
617 LIBERTY ST, CLAY CENTER, KS 67432-1564
(785) 632-2144
(785) 632-3352
Mailing address
PO BOX 512, CLAY CENTER, KS 67432-0512
(785) 632-2144
(785) 632-3352
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
208600000X
Surgery Physician
—
—
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098830C
—
KS
01
—
110947
BLUE SHIELD OF KS
KS
Enumeration date
06/16/2006
Last updated
11/30/2017
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