| Heritage Medical Associates, P.a. | |
| 
					500 W 4th St Peabody KS 66866-1103  | |
| (620) 983-2171 | |
| (620) 983-2575 | 
| Full Name | Heritage Medical Associates, P.a. | 
|---|---|
| Speciality | Family Medicine | 
| Location | 500 W 4th St, Peabody, Kansas | 
| Authorized Official Name and Position | Randolph Richard Whitely (DIRECTOR) | 
| Authorized Official Contact | 6209832171 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Heritage Medical Associates, P.a. 11881 Sw 47th Ter Towanda KS 67144-9264 Ph: (316) 778-2050  | Heritage Medical Associates, P.a. 500 W 4th St Peabody KS 66866-1103 Ph: (620) 983-2171  | 
| NPI Number | 1316998305 | 
|---|---|
| Provider Enumeration Date | 05/14/2006 | 
| Last Update Date | 08/22/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1316998305 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 04-25153 (Kansas) | Primary |