| NPI | 1003938853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANE E MYERS Md 620-235-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0001X |
| Additional Taxonomies | 2085R0001X (Licence: MO R4J03) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2021-06-22 |