Provider Demographics
NPI:1972523454
Name:BRENT A. HRABIK, MD, CHARTERED
Entity Type:Organization
Organization Name:BRENT A. HRABIK, MD, CHARTERED
Other - Org Name:FLINT HILLS FAMILY MEDICINE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:A
Authorized Official - Last Name:HRABIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-343-2500
Mailing Address - Street 1:1301 W 12TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-2587
Mailing Address - Country:US
Mailing Address - Phone:620-343-2500
Mailing Address - Fax:620-343-2828
Practice Address - Street 1:1301 W 12TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801
Practice Address - Country:US
Practice Address - Phone:620-343-2500
Practice Address - Fax:620-343-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-23129207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100370580CMedicaid
KS=========OtherTAX IDENTIFICATION
KS103268Medicare ID - Type Unspecified