Provider Demographics
NPI:1316080245
Name:KANSAS MEDICAL CLINIC PA
Entity type:Organization
Organization Name:KANSAS MEDICAL CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-228-1069
Mailing Address - Street 1:6001 SW 6TH AVE
Mailing Address - Street 2:STE 320
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1006
Mailing Address - Country:US
Mailing Address - Phone:785-271-2256
Mailing Address - Fax:785-271-2276
Practice Address - Street 1:6001 SW 6TH AVE
Practice Address - Street 2:STE 320
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1006
Practice Address - Country:US
Practice Address - Phone:785-271-2256
Practice Address - Fax:785-271-2276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory