Provider Demographics
NPI:1588627384
Name:FAMILY PRACTICE ASSOCIATES OF MCPHERSON, L.L.P.
Entity type:Organization
Organization Name:FAMILY PRACTICE ASSOCIATES OF MCPHERSON, L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STUCKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-241-7400
Mailing Address - Street 1:1010 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460-2326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1010 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-2326
Practice Address - Country:US
Practice Address - Phone:620-241-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100088950AMedicaid
KS100088950AMedicaid