| St. John Physicians, Inc | |
|
218 W 4th Ave Caney KS 67333-1462 | |
| (620) 879-2182 | |
| (620) 879-2246 |
| Full Name | St. John Physicians, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 218 W 4th Ave, Caney, Kansas |
| Authorized Official Name and Position | Gayle Burden (ADMINISTRATOR) |
| Authorized Official Contact | 9183311090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. John Physicians, Inc 218 W 4th Ave Caney KS 67333-1462 Ph: (620) 879-2182 | St. John Physicians, Inc 218 W 4th Ave Caney KS 67333-1462 Ph: (620) 879-2182 |
| NPI Number | 1912961418 |
|---|---|
| Provider Enumeration Date | 04/13/2006 |
| Last Update Date | 08/05/2016 |
| Medicare PECOS PAC ID | 2567366495 |
|---|---|
| Medicare Enrollment ID | O20150608002951 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912961418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 1501670 (Kansas) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |