Provider Demographics
NPI:1942559554
Name:WESTERN PLAINS PHYSICIAN PRACTICES,LLC
Entity Type:Organization
Organization Name:WESTERN PLAINS PHYSICIAN PRACTICES,LLC
Other - Org Name:WESTERN PLAINS ORTHOPADEIC ASSOCATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESS
Authorized Official - Middle Name:N
Authorized Official - Last Name:JUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-372-8500
Mailing Address - Street 1:112 ROSS BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801
Mailing Address - Country:US
Mailing Address - Phone:620-371-7092
Mailing Address - Fax:620-371-7130
Practice Address - Street 1:112 ROSS BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801
Practice Address - Country:US
Practice Address - Phone:620-371-7092
Practice Address - Fax:620-371-7130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty