| Advantage Medical Group Llc | |
|
1104 E 23rd St Lawrence KS 66046-5004 | |
| (785) 749-0130 | |
| (785) 749-0132 |
| Full Name | Advantage Medical Group Llc |
|---|---|
| Speciality | General Practice |
| Location | 1104 E 23rd St, Lawrence, Kansas |
| Authorized Official Name and Position | Douglas Knox (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7857490130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advantage Medical Group Llc 1104 E 23rd St Lawrence KS 66046-5004 Ph: (785) 749-0130 | Advantage Medical Group Llc 1104 E 23rd St Lawrence KS 66046-5004 Ph: (785) 749-0130 |
| NPI Number | 1922060128 |
|---|---|
| Provider Enumeration Date | 04/04/2006 |
| Last Update Date | 11/01/2013 |
| Medicare PECOS PAC ID | 7113984048 |
|---|---|
| Medicare Enrollment ID | O20041213000704 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922060128 | NPI | - | NPPES |
| Provider Name | Douglas B Knox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043212293 PECOS PAC ID: 3870489222 Enrollment ID: I20040503000543 |
| Provider Name | James T Brady |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1831142694 PECOS PAC ID: 6800853730 Enrollment ID: I20041215000844 |
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