Individual
CECILIA MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
536 W 4TH AVE, GARNETT, KS 66032-1355
(785) 448-2674
Mailing address
PO BOX 505408, SAINT LOUIS, MO 63150-5408
(785) 448-3131
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-48548
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2020
Last updated
10/30/2023
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