Provider Demographics
NPI:1316176662
Name:INTEGRITAS MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:INTEGRITAS MEDICAL ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PA
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDHOLM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-628-4955
Mailing Address - Street 1:114 N. MAIN
Mailing Address - Street 2:P.O. BOX 504
Mailing Address - City:CANTON
Mailing Address - State:KS
Mailing Address - Zip Code:67428
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:114 N. MAIN
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:KS
Practice Address - Zip Code:67428
Practice Address - Country:US
Practice Address - Phone:620-628-4955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-08
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty