| Solomon Valley Family Medicine Pa | |
|
1210 N. Washington Plainville KS 67663-1632 | |
| (785) 259-6417 | |
| (785) 434-2577 |
| Full Name | Solomon Valley Family Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1210 N. Washington, Plainville, Kansas |
| Authorized Official Name and Position | Michael A Oller (CO-OWNER) |
| Authorized Official Contact | 7852596417 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Solomon Valley Family Medicine Pa 1210 N. Washington Plainville KS 67663-1632 Ph: (785) 259-6417 | Solomon Valley Family Medicine Pa 1210 N. Washington Plainville KS 67663-1632 Ph: (785) 259-6417 |
| NPI Number | 1730476979 |
|---|---|
| Provider Enumeration Date | 07/08/2011 |
| Last Update Date | 10/06/2011 |
| Medicare PECOS PAC ID | 0042482408 |
|---|---|
| Medicare Enrollment ID | O20111006000292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730476979 | NPI | - | NPPES |
| PENDING | Medicaid | KS | |
| PENDING | Other | KS | BCBS |
| PENDING | Other | KS | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 04-34096 (Kansas) | Primary |
| Provider Name | Beth L Oller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629236393 PECOS PAC ID: 4587847975 Enrollment ID: I20110322001015 |
| Provider Name | Michael A Oller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740441906 PECOS PAC ID: 4082897855 Enrollment ID: I20110401000032 |
Prairie Star Family Practice, P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1210 N. Washington, Clinic B, Plainville, KS 67663 Phone: 785-434-2622 Fax: 785-434-2577 | |
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