Organization
PINNACLE SPORTS MEDICINE & ORTHOPAEDICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON FUNK (CEO)
(620) 663-4800
Entity
Organization
Contact information
Practice address
1818 E 23RD AVE, HUTCHINSON, KS 67502-1106
(620) 662-6000
(620) 669-2394
Mailing address
1818 E 23RD AVE, HUTCHINSON, KS 67502-1106
(620) 662-6000
(620) 669-2394
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110633
BLUE CROSS PROVIDER NUMBE
KS
01
—
4705300001
DMERC PROVIDER NUMBER
KS
Enumeration date
07/26/2006
Last updated
08/22/2020
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