Organization
F ALLEN MOORHEAD JR
Active
Other names
F. Allen Moorhead Jr., M.D. Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK ALLEN MOORHEAD JR. M.D. (OWNER/PHYSICIAN)
(620) 325-2200
Entity
Organization
Contact information
Practice address
709 MAIN ST, NEODESHA, KS 66757-1634
(620) 325-2200
(620) 325-2410
Mailing address
709 MAIN ST, PO BOX 180, NEODESHA, KS 66757-1634
(620) 325-2200
(620) 325-2410
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
04-13549
KS
261QR1300X
Rural Health Clinic/Center
Primary
178917
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100081690B
—
KS
01
—
1066
BC RHC NUMBER
KS
01
—
107098
BLUE CROSS BLUE SHIELD OF KANSAS
KS
Enumeration date
06/01/2005
Last updated
01/22/2010
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