| Lane County Medical Clinic | |
|
444 West Long St. Dighton KS 67839-0488 | |
| (620) 397-5316 | |
| (620) 397-2264 |
| Full Name | Lane County Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 444 West Long St., Dighton, Kansas |
| Authorized Official Name and Position | Donna L Mcgowan (CEO) |
| Authorized Official Contact | 6203975321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lane County Medical Clinic Po Box 488 Dighton KS 67839-0488 Ph: (620) 397-5316 | Lane County Medical Clinic 444 West Long St. Dighton KS 67839-0488 Ph: (620) 397-5316 |
| NPI Number | 1407811227 |
|---|---|
| Provider Enumeration Date | 04/18/2006 |
| Last Update Date | 10/10/2014 |
| Medicare PECOS PAC ID | 1557314358 |
|---|---|
| Medicare Enrollment ID | O20050221000727 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407811227 | NPI | - | NPPES |
| 016536 | Other | KS | BCBS |
| 100098890D | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | H051001 (Kansas) | Primary |
| Provider Name | Jenifer P Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104809987 PECOS PAC ID: 9931165008 Enrollment ID: I20041209000804 |
| Provider Name | Timothy Lawton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780686063 PECOS PAC ID: 5193765451 Enrollment ID: I20050506000139 |
| Provider Name | Kyle L Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821420126 PECOS PAC ID: 1951530625 Enrollment ID: I20140130000176 |
| Provider Name | Jose L Renteria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053704361 PECOS PAC ID: 1951629963 Enrollment ID: I20150422001832 |
| Provider Name | Justen G Watkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689090060 PECOS PAC ID: 0941584254 Enrollment ID: I20211014001701 |
Dighton Usd #482 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 544 E Pearl St, Dighton, KS 67839 Phone: 620-397-2835 | |
Snodgrass Rural Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N Main St, Dighton, KS 67839 Phone: 620-397-5280 Fax: 620-397-5275 |