Provider Demographics
NPI:1093808404
Name:TONGANOXIE FAMILY CARE
Entity Type:Organization
Organization Name:TONGANOXIE FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:PAQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-596-4000
Mailing Address - Street 1:PO BOX 12406
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-0406
Mailing Address - Country:US
Mailing Address - Phone:913-369-2353
Mailing Address - Fax:913-845-2258
Practice Address - Street 1:508 E 4TH ST
Practice Address - Street 2:
Practice Address - City:TONGANOXIE
Practice Address - State:KS
Practice Address - Zip Code:66086-8920
Practice Address - Country:US
Practice Address - Phone:913-369-2353
Practice Address - Fax:913-845-2258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
26114019OtherBCBS KANSAS
26114019OtherBCBS KANSAS