| Ohaebosim Medical Clinic Inc | |
|
2810 E 21st Street Wichita KS 67214-2252 | |
| (316) 681-1901 | |
| (316) 618-7362 |
| Full Name | Ohaebosim Medical Clinic Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2810 E 21st Street, Wichita, Kansas |
| Authorized Official Name and Position | Linus C Ohaebosim (OWNER PRESIDENT) |
| Authorized Official Contact | 3166811901 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ohaebosim Medical Clinic Inc 2810 E 21st Street Wichita KS 67214-2252 Ph: (316) 681-1901 | Ohaebosim Medical Clinic Inc 2810 E 21st Street Wichita KS 67214-2252 Ph: (316) 681-1901 |
| NPI Number | 1497829261 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 12/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497829261 | NPI | - | NPPES |
| 614790 | Other | FIRST GUARD | |
| 693 | Other | KS | PHS |
| 49202 | Other | KS | BLUE SHIELD |
| 4083832 | Other | AETNA | |
| 100098690A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0516911 (Kansas) | Primary |
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