| Irick Family Medicine, Pa | |
|
15270 W 119th St Olathe KS 66062-5604 | |
| (913) 829-8833 | |
| (913) 768-4827 |
| Full Name | Irick Family Medicine, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 15270 W 119th St, Olathe, Kansas |
| Authorized Official Name and Position | Constance M Irick (OWNER) |
| Authorized Official Contact | 9138298833 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Irick Family Medicine, Pa 15270 W 119th St Olathe KS 66062-5604 Ph: (913) 829-8833 | Irick Family Medicine, Pa 15270 W 119th St Olathe KS 66062-5604 Ph: (913) 829-8833 |
| NPI Number | 1346427028 |
|---|---|
| Provider Enumeration Date | 01/25/2008 |
| Last Update Date | 02/12/2010 |
| Medicare PECOS PAC ID | 1658440409 |
|---|---|
| Medicare Enrollment ID | O20080520000134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346427028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 04-22030 (Kansas) | Primary |
| Provider Name | Constance Marie Irick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346235272 PECOS PAC ID: 1052384518 Enrollment ID: I20040813000853 |
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