Provider Demographics
NPI:1790295210
Name:FAMILYMED PA
Entity Type:Organization
Organization Name:FAMILYMED PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SEELING
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:913-527-2720
Mailing Address - Street 1:22450 S HARRISON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:KS
Mailing Address - Zip Code:66083-8882
Mailing Address - Country:US
Mailing Address - Phone:913-527-2720
Mailing Address - Fax:
Practice Address - Street 1:22450 S HARRISON ST STE 100
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:KS
Practice Address - Zip Code:66083-8882
Practice Address - Country:US
Practice Address - Phone:913-527-2720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty