| Jerad Widman | |
|
22450 S Harrison St Suite 100 Spring Hill KS 66083-8882 | |
| (913) 592-2720 | |
| (913) 592-2725 |
| Full Name | Jerad Widman |
|---|---|
| Speciality | Family Medicine |
| Location | 22450 S Harrison St, Spring Hill, Kansas |
| Authorized Official Name and Position | Ali Seeling (PRACTICE MANAGER) |
| Authorized Official Contact | 9135922720 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerad Widman 22450 S Harrison St Suite 100 Spring Hill KS 66083-8882 Ph: (913) 592-2720 | Jerad Widman 22450 S Harrison St Suite 100 Spring Hill KS 66083-8882 Ph: (913) 592-2720 |
| NPI Number | 1871780825 |
|---|---|
| Provider Enumeration Date | 10/03/2007 |
| Last Update Date | 08/16/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871780825 | NPI | - | NPPES |
| 35084012 | Other | BLUE CROSS BLUE SHIELD KC | |
| 200300220D | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | KS0430763 (Kansas) | Primary |
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