BOB WILSON MEMORIAL GRANT COUNTY NPI 1497730071

NPI Information

BOB WILSON MEMORIAL GRANT COUNTY is a rural health clinic center in Ulysses, KS. BOB WILSON MEMORIAL GRANT COUNTY NPI is 1497730071. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ulysses Family Physicians.

The provider's business location address is:

505 N MAIN ST
ULYSSES, KS
ZIP 67880-135
Phone: (620) 356-1261
Fax: (620) 356-3846

The provider's authorized official is Karla Ann Nichols .
The authorized official title is Clinic Administrator and has the following contact phone number (620) 356-1261.

The CLIA number assigned to this NPI record is 17D0453296 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/7/2005 and was last updated on 3/3/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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