Provider Demographics
NPI:1598795544
Name:SEARIGHT FAMILY PRACTICE PA
Entity Type:Organization
Organization Name:SEARIGHT FAMILY PRACTICE PA
Other - Org Name:GOFF MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KROGMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-866-4775
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:GOFF MEDICAL CLINIC
Mailing Address - City:WETMORE
Mailing Address - State:KS
Mailing Address - Zip Code:66550-0249
Mailing Address - Country:US
Mailing Address - Phone:785-866-4775
Mailing Address - Fax:785-866-4204
Practice Address - Street 1:323 SECOND ST
Practice Address - Street 2:GOFF MEDICAL CLINIC
Practice Address - City:WETMORE
Practice Address - State:KS
Practice Address - Zip Code:66550-0249
Practice Address - Country:US
Practice Address - Phone:785-866-4775
Practice Address - Fax:785-866-4204
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEARIGHT FAMILY PRACTICE PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-04
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04 19703207Q00000X
305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100291070BMedicaid
KS111034OtherBLUE CROSS BLUE SHIELD
KSB91103Medicare UPIN
KS173859Medicare ID - Type Unspecified
160106HEMedicare PIN