Organization
ADVANCED SURGICAL WEIGHT LOSS, CHARTERED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY JAMES CANFIELD MD, FACS (PRESIDENT)
(620) 626-6448
Entity
Organization
Contact information
Practice address
555 W 15TH ST, SUITE B, LIBERAL, KS 67901-2467
(620) 626-6448
(620) 626-7040
Mailing address
555 W 15TH ST, SUITE B, LIBERAL, KS 67901-2467
(620) 626-6448
(620) 626-7040
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
04-27942
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103579
BLUE CROSS BLUE SHIELD
KS
Enumeration date
08/31/2006
Last updated
08/22/2020
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