Organization
PRATT INTERNAL MEDICINE GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL J SUITER M.D. (PRESIDENT OF CORPORATION)
(620) 672-7415
Entity
Organization
Contact information
Practice address
420 COUNTRY CLUB RD, PRATT, KS 67124-3125
(620) 672-7415
(620) 672-7414
Mailing address
420 COUNTRY CLUB RD, PRATT, KS 67124-3125
(620) 672-7415
(620) 672-7414
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000811
RURAL HEALTH BLUE CROSS
KS
05
—
100088840B
—
KS
Enumeration date
05/31/2006
Last updated
02/04/2014
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