Provider Demographics
NPI:1992874176
Name:LAWRENCE-DOUGLAS COUNTY HEALTH DEPT
Entity type:Organization
Organization Name:LAWRENCE-DOUGLAS COUNTY HEALTH DEPT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-843-3060
Mailing Address - Street 1:200 MAINE STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044
Mailing Address - Country:US
Mailing Address - Phone:785-843-3060
Mailing Address - Fax:785-843-3161
Practice Address - Street 1:200 MAINE STREET
Practice Address - Street 2:SUITE B
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044
Practice Address - Country:US
Practice Address - Phone:785-843-3060
Practice Address - Fax:785-843-3161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100097770AMedicaid
KS012717OtherBLUE CROSS & BLUE SHIELD