Provider Demographics
NPI:1578766499
Name:FAMILY PHYSICIANS P A
Entity Type:Organization
Organization Name:FAMILY PHYSICIANS P A
Other - Org Name:THE FAMILY PHYSICIANS, P.A.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-365-3115
Mailing Address - Street 1:112 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLONY
Mailing Address - State:KS
Mailing Address - Zip Code:66015-7286
Mailing Address - Country:US
Mailing Address - Phone:620-852-3550
Mailing Address - Fax:620-852-3462
Practice Address - Street 1:1408 EAST STREET
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-3004
Practice Address - Country:US
Practice Address - Phone:620-365-3115
Practice Address - Fax:620-365-7717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100215590AMedicaid
KS016668Medicare ID - Type UnspecifiedMEDICARE PART B