Desoto Family Practice, LLC
Organization Active NPI Family Medicine Physician · De Soto, KS
NPI 1407891732 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1407891732
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- DESOTO FAMILY PRACTICE, LLC
- Practice address
- 33490 Lexington Ave
De Soto, KS 66018-8269 - Phone
- (913) 583-1179
- NPI assigned
- Jun 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Ken Washington
- Title
- VP
- Phone
- (913) 583-1179
National Provider Directory
Locations
33490 Lexington Ave
De Soto, KS 66018
Phone (913) 583-1179
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
33490 Lexington Ave
De Soto, KS 66018-8269
Mailing address
33490 Lexington Ave
De Soto, KS 66018-8269
Phone (913) 583-1179
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17436020 | Other | KS | BCBS OF KANSAS |
| 20-877756-01 | Medicaid | KS |
Other providers in De Soto, KS
- Nana Amma Asante
- Biodesix, Inc.
- James Burdette Boyes
- Henry Wesley Brame Jr.
- Central Medical Laboratory, LLC
- Desoto Usd 232
- William Dolan
- Don Reith, DC, PA
- Family Eyecare Center of Desoto Kansas LLC
- Free State Dental
All providers in De Soto, KS · Family Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.