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Organization

ASHLEY CLINIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT K THOMEN II M.D. (PHYSICIAN OWNER)
(620) 431-2500
Entity
Organization

Contact information

Practice address
505 S PLUMMER AVE, CHANUTE, KS 66720-1950
(620) 431-2500
(620) 431-4418
Mailing address
PO BOX 946, CHANUTE, KS 66720-0946
(620) 431-2500
(620) 431-4418

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207VX0000X
Obstetrics Physician
207X00000X
Orthopaedic Surgery Physician
208000000X
Pediatrics Physician
208600000X
Surgery Physician
208800000X
Urology Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003879
BLUE CROSS/BLUE SHIELD
KS
05
100080330A
KS
Enumeration date
10/16/2006
Last updated
01/23/2018
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