Organization
MUDDY CREEK FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL L. KEEHN M.D. (OWNER)
(785) 933-2000
Entity
Organization
Contact information
Practice address
200 WHITE WAY ST, NETAWAKA, KS 66516-9378
(785) 933-2000
(785) 933-2022
Mailing address
200 WHITE WAY ST, NETAWAKA, KS 66516-9378
(785) 933-2000
(785) 933-2022
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0424501
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0424501
STATE LICENSE
KS
01
—
DG5340
MEDICARE RAILROAD
KS
Enumeration date
08/09/2006
Last updated
02/04/2008
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