Organization
BOB WILSON MEMORIAL GRANT COUNTY
Active
Other names
Ulysses Family Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARLA ANN NICHOLS (CLINIC ADMINISTRATOR)
(620) 356-1261
Entity
Organization
Contact information
Practice address
505 N MAIN ST, ULYSSES, KS 67880-2135
(620) 356-1261
(620) 356-3846
Mailing address
505 N MAIN ST, ULYSSES, KS 67880-2135
(620) 356-1261
(620) 356-3846
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
KS
261QR1300X
Rural Health Clinic/Center
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100282430A
—
KS
05
—
100282430B
—
KS
01
—
110236
BC/BS
KS
Enumeration date
12/07/2005
Last updated
03/03/2010
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