Organization
FAMILY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK NEIL VINZANT M.D. (MEDICAL DIRECTOR)
(316) 788-3741
Entity
Organization
Contact information
Practice address
1410 N WOODLAWN BLVD, SUITE A, DERBY, KS 67037-2922
(316) 788-3741
Mailing address
1410 N WOODLAWN BLVD, SUITE A, DERBY, KS 67037-2922
(316) 788-3741
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0417161
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016429
MEDICARE GROUP #
KS
Enumeration date
01/26/2007
Last updated
03/20/2008
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