Organization
AXTELL CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISHA MALO RN (ADMINISTRATOR)
(316) 283-2800
Entity
Organization
Contact information
Practice address
700 MEDICAL CENTER DRIVE, SUITE 210, NEWTON, KS 67114-9017
(316) 283-2800
(316) 283-3575
Mailing address
700 MEDICAL CENTER DRIVE, SUITE 210, NEWTON, KS 67114-9017
(316) 283-2800
(316) 283-3575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003230A
—
KS
Enumeration date
06/21/2006
Last updated
01/14/2021
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