Provider Demographics
NPI:1689717100
Name:ATCHISON FAMILY MEDICINE, P.A.
Entity Type:Organization
Organization Name:ATCHISON FAMILY MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:EPLEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-367-1623
Mailing Address - Street 1:820 RAVEN HILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-9230
Mailing Address - Country:US
Mailing Address - Phone:913-367-1623
Mailing Address - Fax:913-367-7297
Practice Address - Street 1:820 RAVEN HILL DRIVE
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-9230
Practice Address - Country:US
Practice Address - Phone:913-367-1623
Practice Address - Fax:913-367-7297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0418237207Q00000X
261QR1300X
KS1500590363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS178993Medicare Oscar/Certification
KSB68755Medicare UPIN