Provider Demographics
NPI:1881644540
Name:NEW MARKET HEALTH CARE LLC
Entity Type:Organization
Organization Name:NEW MARKET HEALTH CARE LLC
Other - Org Name:NEW MEDICAL HEALTH CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:F
Authorized Official - Last Name:LAKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO, JD
Authorized Official - Phone:316-773-1212
Mailing Address - Street 1:P O BOX 1389
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-1389
Mailing Address - Country:US
Mailing Address - Phone:316-773-1212
Mailing Address - Fax:316-440-6601
Practice Address - Street 1:2131 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-1570
Practice Address - Country:US
Practice Address - Phone:316-773-1212
Practice Address - Fax:316-440-6601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200000670AMedicaid
KS110965OtherBCBS
KS110965OtherBCBS