Provider Demographics
NPI:1831237528
Name:FORT HAYS STATE UNIVERSITY
Entity type:Organization
Organization Name:FORT HAYS STATE UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FOR ADMINISTRATION AND FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-628-4251
Mailing Address - Street 1:600 PARK ST
Mailing Address - Street 2:LL045MU
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-4009
Mailing Address - Country:US
Mailing Address - Phone:785-628-4678
Mailing Address - Fax:785-628-4089
Practice Address - Street 1:600 PARK ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-4009
Practice Address - Country:US
Practice Address - Phone:785-628-4293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44467251300000X
KS04-16850207R00000X
261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No251300000XAgenciesLocal Education Agency (LEA)Group - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty