| Kiowa District Hospital | |
|
1002 S 4th St Kiowa KS 67070-1825 | |
| (620) 825-4131 | |
| (620) 825-4753 |
| Full Name | Kiowa District Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 1002 S 4th St, Kiowa, Kansas |
| Authorized Official Name and Position | Steve Davis (INTERIM CEO) |
| Authorized Official Contact | 6208254131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kiowa District Hospital 1002 S 4th St Kiowa KS 67070-1825 Ph: (620) 825-4131 | Kiowa District Hospital 1002 S 4th St Kiowa KS 67070-1825 Ph: (620) 825-4131 |
| NPI Number | 1619960101 |
|---|---|
| Provider Enumeration Date | 08/30/2005 |
| Last Update Date | 11/18/2020 |
| Medicare PECOS PAC ID | 8325020670 |
|---|---|
| Medicare Enrollment ID | O20041130000965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619960101 | NPI | - | NPPES |
| 110083 | Other | KS | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Kirk R Bliss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043224603 PECOS PAC ID: 5193713428 Enrollment ID: I20040504001556 |
| Provider Name | Paul Gerard Wilhelm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518959873 PECOS PAC ID: 8426027640 Enrollment ID: I20040924000914 |
| Provider Name | Kc L Wetta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992108443 PECOS PAC ID: 7012138795 Enrollment ID: I20141021003118 |
| Provider Name | Mary Elizabeth Wilkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124574066 PECOS PAC ID: 1951682855 Enrollment ID: I20180207002926 |
| Provider Name | Morgan Michelle Stuke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184260374 PECOS PAC ID: 5991131427 Enrollment ID: I20200131002530 |
| Provider Name | Dedra R Rathgeber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902488505 PECOS PAC ID: 4385045194 Enrollment ID: I20210630004157 |
Kiowa District Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1002 S 4th St, Kiowa, KS 67070 Phone: 620-825-4131 Fax: 620-825-4667 |