Provider Demographics
NPI:1538123708
Name:OPTIMUM HEALTH FAMILY PRACTICE
Entity Type:Organization
Organization Name:OPTIMUM HEALTH FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE LIASION
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KOBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-228-2277
Mailing Address - Street 1:2840 SW URISH RD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-5614
Mailing Address - Country:US
Mailing Address - Phone:785-228-2277
Mailing Address - Fax:785-228-9892
Practice Address - Street 1:2840 SW URISH RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5614
Practice Address - Country:US
Practice Address - Phone:785-228-2277
Practice Address - Fax:785-228-9892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty