Organization
LIFELINE FAMILY MEDICINE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN R FISHER M.D. (OWNER/PRESIDENT)
(785) 434-2622
Entity
Organization
Contact information
Practice address
1210 N. WASHINGTON, CLINIC B, PLAINVILLE, KS 67663
(785) 434-2622
(785) 434-2577
Mailing address
1210 N. WASHINGTON, CLINIC B, P.O. BOX 407, PLAINVILLE, KS 67663-0407
(785) 434-2622
(785) 434-2577
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-30818
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105275
BC/BS INDIVIDUAL
KS
01
—
111215
BC/BS GROUP
KS
05
—
200269400C
—
KS
01
—
482220
FIRSTGUARD
KS
Enumeration date
08/20/2006
Last updated
07/08/2010
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