| Bryan C. Davis, M.d., P.a. | |
|
1305 E 19th Ave Winfield KS 67156-5201 | |
| (620) 221-9500 | |
| (620) 221-3700 |
| Full Name | Bryan C. Davis, M.d., P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 1305 E 19th Ave, Winfield, Kansas |
| Authorized Official Name and Position | Bryan C. Davis (OWNER) |
| Authorized Official Contact | 6202219500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bryan C. Davis, M.d., P.a. 1305 E 19th Ave Winfield KS 67156-5201 Ph: (620) 221-9500 | Bryan C. Davis, M.d., P.a. 1305 E 19th Ave Winfield KS 67156-5201 Ph: (620) 221-9500 |
| NPI Number | 1235243023 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 08/29/2011 |
| Medicare PECOS PAC ID | 0446246235 |
|---|---|
| Medicare Enrollment ID | O20040426000807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235243023 | NPI | - | NPPES |
| 100327700C | Medicaid | KS | |
| 336640 | Other | KS | FIRSTGUARD |
| 130330 | Other | KS | BC/BS OF KANSAS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 04-27652 (* (Not Available)) | Primary |
| Provider Name | Deborah S Love |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982679528 PECOS PAC ID: 2961468061 Enrollment ID: I20041209000311 |
| Provider Name | Bryan C Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053425934 PECOS PAC ID: 8022005818 Enrollment ID: I20050609001026 |
| Provider Name | Bonnie J Huss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750504197 PECOS PAC ID: 4082669486 Enrollment ID: I20100805000456 |
| Provider Name | Carrie A Parmley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538606769 PECOS PAC ID: 2264719020 Enrollment ID: I20170503001502 |
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