Basic Information
| Provider Information | |||||||||
| NPI: | 1205949674 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FLINTHILLS OB/GYN P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1110 SAINT MARYS RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | JUNCTION CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 664414228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852235555 | ||||||||
| FaxNumber: | 7852236611 | ||||||||
| Practice Location | |||||||||
| Address1: | 1110 SAINT MARYS RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | JUNCTION CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 664414228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852235555 | ||||||||
| FaxNumber: | 7852236611 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | KHOURY | ||||||||
| AuthorizedOfficialFirstName: | ANWAR | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7852235555 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 0426286 | KS | X | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Other Service Providers | Specialist | 176B00000X | 64086 | KS | X | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Other Service Providers | Midwife |
No ID Information.