Organization
THE FAMILY PHYSICIANS PA
Active
Other names
Family Physicians P A
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA ELAINE O'CONNOR (ADMINISTRATOR)
(620) 365-3115
Entity
Organization
Contact information
Practice address
1408 EAST ST, IOLA, KS 66749-4402
(620) 365-3115
(620) 365-7717
Mailing address
1408 EAST STREET, IOLA, KS 66749-3004
(620) 365-3115
(620) 365-7717
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
178969
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100215590B
—
KS
01
—
1550
BLUE CROSS RHC
KS
01
—
178969
RURAL HEALTH IDENTIFICATION
KS
01
—
17D0450573
CLIA WAIVER
—
Enumeration date
07/10/2006
Last updated
10/04/2024
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