Organization
C&S MEDICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS SANDOVAL (OFFICE MANAGER)
(620) 408-9700
Entity
Organization
Contact information
Practice address
2200 SUMMERLON CIRCLE, SUITE A, DODGE CITY, KS 67801-2905
(620) 408-9700
(620) 408-9701
Mailing address
2200 SUMMERLON CIRCLE, SUITE A, DODGE CITY, KS 67801-2905
(620) 408-9700
(620) 408-9701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100451610A
—
KS
Enumeration date
05/24/2006
Last updated
02/15/2012
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