| Snodgrass Memorial Clinic, Llc | |
|
2200 Summerlon Cir Ste A Dodge City KS 67801-2905 | |
| (620) 408-9700 | |
| (620) 408-9701 |
| Full Name | Snodgrass Memorial Clinic, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2200 Summerlon Cir Ste A, Dodge City, Kansas |
| Authorized Official Name and Position | Marcia M Snodgrass (OWNER) |
| Authorized Official Contact | 6204089700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Snodgrass Memorial Clinic, Llc 20854 Sw 213 Rd Jetmore KS 67854-5358 Ph: (620) 357-1003 | Snodgrass Memorial Clinic, Llc 2200 Summerlon Cir Ste A Dodge City KS 67801-2905 Ph: (620) 408-9700 |
| NPI Number | 1942930094 |
|---|---|
| Provider Enumeration Date | 06/13/2022 |
| Last Update Date | 06/13/2022 |
| Medicare PECOS PAC ID | 5698122141 |
|---|---|
| Medicare Enrollment ID | O20231106002206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942930094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Marcia Marie Snodgrass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184617011 PECOS PAC ID: 9830092535 Enrollment ID: I20210729001216 |
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