Provider Demographics
NPI:1285847798
Name:ARTHRITIS CENTER OF NEO
Entity Type:Organization
Organization Name:ARTHRITIS CENTER OF NEO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:PROF
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROTHSCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-856-2889
Mailing Address - Street 1:529 E 1700TH RD
Mailing Address - Street 2:
Mailing Address - City:BALDWIN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66006-8228
Mailing Address - Country:US
Mailing Address - Phone:785-856-2889
Mailing Address - Fax:785-841-0866
Practice Address - Street 1:930 IOWA ST STE 2
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1869
Practice Address - Country:US
Practice Address - Phone:785-856-2889
Practice Address - Fax:785-841-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35053672261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0641596Medicaid
KS111130Medicare PIN
OH9255151Medicare PIN
OH0641596Medicaid