Organization
ROOKS COUNTY MEDICAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN RENEE TAYLOR DO (PRESIDENT)
(785) 425-6417
Entity
Organization
Contact information
Practice address
623 S 2ND ST, STOCKTON, KS 67669-1966
(785) 425-6417
(785) 425-6138
Mailing address
623 S 2ND ST, STOCKTON, KS 67669-1966
(785) 425-6417
(785) 425-6138
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
05 28153
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080179741
RAILROAD MEDICARE
KS
01
—
100429910B
MEDICAID FACILITY
KS
01
—
110843
BC BS
KS
05
—
2087670501
—
KS
Enumeration date
12/13/2005
Last updated
06/23/2008
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