Organization
JEAN-MICHEL, HASSAN, MD SOUTHWEST CLINIC INC
Active
Other names
SOUTHWEST CLINIC INC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEAN MICHEL HASSAN MD (PHYSICIAN OWNER)
(620) 626-4368
Entity
Organization
Contact information
Practice address
555 W 15TH ST STE D, LIBERAL, KS 67901-2468
(620) 626-4368
(620) 626-7370
Mailing address
555 W 15TH ST STE D, LIBERAL, KS 67901-2468
(620) 626-4368
(620) 626-7370
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
0431410
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111347
MEDICARE
KS
Enumeration date
03/21/2007
Last updated
02/13/2008
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