Bob Wilson Memorial Grant County

Organization Active NPI Rural Health Clinic/Center · Ulysses, KS

NPI 1497730071 · NPPES record last updated Mar 3, 2010

Key facts

NPI
1497730071
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
BOB WILSON MEMORIAL GRANT COUNTY
Practice address
505 N Main St
Ulysses, KS 67880-2135
Phone
(620) 356-1261
Fax
(620) 356-3846
NPI assigned
Dec 7, 2005
Organization subpart
No

Authorized official

Name
Mrs. Karla Ann Nichols
Title
Clinic Administrator
Phone
(620) 356-1261

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X KS
Rural Health Clinic/Center 261QR1300X KS Yes

Addresses

Primary practice location

505 N Main St
Ulysses, KS 67880-2135

Mailing address

505 N Main St
Ulysses, KS 67880-2135
Phone (620) 356-1261

Other identifiers

IdentifierTypeStateIssuer
100282430AMedicaidKS
110236OtherKSBC/BS
100282430BMedicaidKS

Other names

  • Ulysses Family Physicians Doing business as

Other providers in Ulysses, KS

All providers in Ulysses, KS · Rural Health Clinic/Center in Kansas

Sources for this page

Verify at the official NPI Registry.