| Erickson Medical Clinic, Llc | |
|
409 Lincoln Ave Clay Center KS 67432-2907 | |
| (785) 632-6415 | |
| Not Available |
| Full Name | Erickson Medical Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 409 Lincoln Ave, Clay Center, Kansas |
| Authorized Official Name and Position | Kent Edwin Erickson (PRESIDENT, MEMBER, OWNER) |
| Authorized Official Contact | 7856326415 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Erickson Medical Clinic, Llc 1024 Lane St Clay Center KS 67432-2211 Ph: (785) 632-6415 | Erickson Medical Clinic, Llc 409 Lincoln Ave Clay Center KS 67432-2907 Ph: (785) 632-6415 |
| NPI Number | 1689029464 |
|---|---|
| Provider Enumeration Date | 04/28/2016 |
| Last Update Date | 04/28/2016 |
| Medicare PECOS PAC ID | 1456648740 |
|---|---|
| Medicare Enrollment ID | O20160930000677 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689029464 | NPI | - | NPPES |
| 100208950A | Medicaid | KS | |
| 18630 | Other | KS | MEDICARE |
| 003863 | Other | KS | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | IN PROGRESS (Kansas) | Primary |
| Provider Name | Kent Edwin Erickson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073516035 PECOS PAC ID: 4688611734 Enrollment ID: I20050411001087 |
| Provider Name | Kathryn Ann Heins-erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861852469 PECOS PAC ID: 6901102185 Enrollment ID: I20160315000678 |
Clay County Health Department Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 820 Spellman Cir, Clay Center, KS 67432 Phone: 785-632-3193 Fax: 785-632-5849 | |
Clay Center Family Physicians Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 609 Liberty St, Clay Center, KS 67432 Phone: 785-632-2181 | |
Associates In Primary Care, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 711 Liberty St, Clay Center, KS 67432 Phone: 785-632-2000 Fax: 785-632-2014 | |
Clay Center Family Physicians Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 609 Liberty St, Clay Center, KS 67432 Phone: 785-632-2181 Fax: 785-632-2309 |