Provider Demographics
NPI:1598201915
Name:URGENT CARE OF COWLEY COUNTY LLC
Entity Type:Organization
Organization Name:URGENT CARE OF COWLEY COUNTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-221-9500
Mailing Address - Street 1:1305 E 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-5201
Mailing Address - Country:US
Mailing Address - Phone:620-221-9500
Mailing Address - Fax:620-229-8500
Practice Address - Street 1:1305 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-5201
Practice Address - Country:US
Practice Address - Phone:620-221-9500
Practice Address - Fax:620-229-8500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care