Provider Demographics
NPI:1710180823
Name:RAINBOW HILL FAMILY PRACTICE
Entity Type:Organization
Organization Name:RAINBOW HILL FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-364-4445
Mailing Address - Street 1:713 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLTON
Mailing Address - State:KS
Mailing Address - Zip Code:66436-1412
Mailing Address - Country:US
Mailing Address - Phone:785-364-4445
Mailing Address - Fax:
Practice Address - Street 1:713 W 7TH ST
Practice Address - Street 2:
Practice Address - City:HOLTON
Practice Address - State:KS
Practice Address - Zip Code:66436-1412
Practice Address - Country:US
Practice Address - Phone:785-364-4445
Practice Address - Fax:785-364-4934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0422190207Q00000X, 305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Not Answered305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS$$$$$$$$$OtherSSN