Provider Demographics
NPI:1477049328
Name:ABOVE ALL CARE CLINIC
Entity Type:Organization
Organization Name:ABOVE ALL CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEFERS
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:785-688-4325
Mailing Address - Street 1:409 S COCHRAN ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67663-2531
Mailing Address - Country:US
Mailing Address - Phone:785-543-5211
Mailing Address - Fax:
Practice Address - Street 1:409 S COCHRAN ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:KS
Practice Address - Zip Code:67663
Practice Address - Country:US
Practice Address - Phone:785-543-5211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00551207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201228130AMedicaid