Medicine Lodge Memorial Hospital Physicians Clinc
Organization Active NPI Critical Access Hospital Clinic/Center · Medicine Lodge, KS
NPI 1831208701 · NPPES record last updated Jul 2, 2024
Key facts
- NPI
- 1831208701
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital Clinic/Center 261QC0050X
- License
- HS004002 (KS)
- Legal business name
- MEDICINE LODGE MEMORIAL HOSPITAL PHYSICIANS CLINC
- Practice address
- 701 N Walnut St
Drawer 'C'
Medicine Lodge, KS 67104-1018 - Phone
- (620) 886-3771
- Fax
- (620) 886-5012
- NPI assigned
- Aug 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Ashley Taylor
- Title
- Administrator
- Phone
- (620) 886-3771
Corporate family (same tax ID) 5
Practitioners 1
-
Ryan M. Fleming, PAC
National Provider Directory
- Tax ID family
- Medicine Lodge Surgery CL
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital Clinic/Center | 261QC0050X | HS004002 | KS | Yes |
Addresses
Primary practice location
701 N Walnut St
Drawer 'C'
Medicine Lodge, KS 67104-1018
Mailing address
701 N. Walnut Street
Drawer 'C'
Medicine Lodge, KS 67104-1018
Phone (620) 886-3771
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100092110B | Medicaid | KS |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MedicineLodge.Hospital@MedicineLodge-GPHA.cernerdirect.com | Direct | |
| Direct Messaging Address | MedicineLodge.Clinic@MedicineLodge-GPHA.cernerdirect.com | Direct |
Other providers in Medicine Lodge, KS
- Medicine Lodge Memorial Hospital
- Medicine Lodge Memorial Hospital
- Medicine Lodge Memorial Hospital
- Medicine Lodge Memorial Hospital
- Medicine Lodge Memorial Hospital
- Donald R. Ransom
- Julie Theresa Thompson
- Connie A Watts
All providers in Medicine Lodge, KS · Critical Access Hospital Clinic/Center in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2024. 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.