| Collin Connor, | |
|
1603 W 4th St, Holton, KS 66436-1153 | |
| (785) 364-3205 | |
| (785) 364-3468 |
| Full Name | Collin Connor |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1603 W 4th St, Holton, Kansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144894734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 94-10492 (Kansas) | Secondary |
| 207Q00000X | Family Medicine | 0449543 (Kansas) | Primary |
| Entity Name | Community Healthcare System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578528824 PECOS PAC ID: 8325031529 Enrollment ID: O20040405000949 |
| Mailing Address | Practice Location Address |
|---|---|
| Collin Connor, 1010 N Kansas St, Wichita, KS 67214-3124 Ph: (316) 293-2665 | Collin Connor, 1603 W 4th St, Holton, KS 66436-1153 Ph: (785) 364-3205 |
Dr. Gary Lee Petry, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1110 Columbine Drive, Holton, KS 66436 Phone: 785-364-2126 Fax: 785-364-2801 | |
Marija Kay Lawless, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1110 Columbine Dr Ste 100, Holton, KS 66436 Phone: 785-364-2126 | |
Vance R Lassey, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 23020 M Rd, Holton, KS 66436 Phone: 785-362-8677 Fax: 785-362-4372 | |
Malia Sm Warner, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1100 Columbine Drive, Holton, KS 66436 Phone: 785-365-2116 Fax: 785-364-9613 | |
Ms. Nancy J Zidek, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1603 W 4th St, Holton, KS 66436 Phone: 785-364-3205 Fax: 785-364-3468 | |
Clint M Colberg, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1100 Columbine Drive, Holton, KS 66436 Phone: 785-364-2116 Fax: 785-364-9613 |