Provider Demographics
NPI:1467825026
Name:ADVANCED MOBILE HEALTHCARE AND COMMUNITY CLINIC
Entity type:Organization
Organization Name:ADVANCED MOBILE HEALTHCARE AND COMMUNITY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:620-491-3725
Mailing Address - Street 1:437 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:KS
Mailing Address - Zip Code:67068-1324
Mailing Address - Country:US
Mailing Address - Phone:620-553-5040
Mailing Address - Fax:620-553-5029
Practice Address - Street 1:437 CEDAR ST
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:KS
Practice Address - Zip Code:67068-1324
Practice Address - Country:US
Practice Address - Phone:620-553-5040
Practice Address - Fax:620-553-5029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-04
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty