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EL DORADO CLINIC P.A. NPI 1780787176


NPI Information

NPI: 1780787176
Provider Name: EL DORADO CLINIC, P.A.

Other Name: EL DORADO CLINIC, P.A., RHC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 17D2080178

Address:
700 W CENTRAL AVE
STE 205
EL DORADO, KS
ZIP 67042
Phone: (316) 321-2010
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EL DORADO CLINIC, P.A. is a rural health clinic center in El Dorado, KS. EL DORADO CLINIC, P.A. NPI is 1780787176. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is El Dorado Clinic, P.a., Rhc.

The provider's business location address is:

700 W CENTRAL AVE
STE 205
EL DORADO, KS
ZIP 67042-184
Phone: (316) 321-2010
Fax: (316) 321-8871

The provider's authorized official is Melissa A Butts .
The authorized official title is Clinic Administrator and has the following contact phone number (316) 321-8850.

The CLIA number assigned to this NPI record is 17D2080178 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/7/2006 and was last updated on 2/7/2019.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2261QR1300XClinic/CenterRural HealthYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1001172OTHERKANSASBCBSKS RHC NUMBER
2100213650BMEDICAIDKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.