Individual
MR. CHARLES EARL VANHOUDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
505 S PLUMMER AVE, CHANUTE, KS 66720-1950
(620) 431-2500
(620) 431-0914
Mailing address
PO BOX 946, CHANUTE, KS 66720-0946
(620) 431-2500
(620) 431-0914
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0417383
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003263
BLUE CROSS & BLUE SHIELD
KS
01
—
020020291
RAIL ROAD MEDICARE
—
05
—
100087520A
—
KS
01
—
600530
FIRSTGUARD
KS
01
—
66720A018
TRICARE
—
Enumeration date
06/22/2005
Last updated
07/08/2007
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