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Organization

COTTONWOOD PEDIATRICS, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SUE ANN JANTZ (ADMINISTRATOR)
(316) 283-7100
Entity
Organization

Contact information

Practice address
700 MEDICAL CENTER DR, STE 150, NEWTON, KS 67114-9015
(316) 283-7100
(316) 283-7118
Mailing address
PO BOX 725, NEWTON, KS 67114-0725
(316) 283-3627
(316) 283-3635

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0422944
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100403
HEALTH PARTNERS OF KANSAS
KS
01
111290
BLUE CROSS / BLUE SHIELD
KS
01
1615419
FIRST HEALTH
KS
01
193782
COVENTRY
KS
05
20418430A
KS
01
841639497
CENTURY HEALTH
KS
Enumeration date
05/27/2005
Last updated
11/16/2022
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