Spectrum Family Medical Clinic, Pa

LBN: Spectrum Family Medical Clinic, Pa
Spectrum Family Medical Clinic, Pa is an health care organization with primary practice located at 2020 N Tyler Ste 114, Wichita KS 67212-4916. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Spectrum Family Medical Clinic, Pa can be contacted via phone (316) 462-0460, or through Mann, Phaedra M via phone (316) 462-0460.

Contact Information

Primary practice address
2020 N Tyler Ste 114 Wichita KS 67212-4916
Phone: (316) 462-0460
Fax: (316) 462-0465
Website:
Map and Directions
Authorized official contact:
Name: Mann, Phaedra M
Phone: (316) 462-0460

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0422366 Kansas

Profile Details

NPI number 1912963067
LBN Legal business name Spectrum Family Medical Clinic, Pa
DBA Doing business as
Authorized official Mann, Phaedra M
Entity Organization
Organization subpart 1 No
Enumeration date Apr 25th, 2006
Last updated Oct 5th, 2017 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912963067 NPPES
Kansas MEDICAID 100112800C

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