| NPI | 1184736563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME BLOCK Owner 620-251-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 0420630) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 44318) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |