Basic Information
| Provider Information | |||||||||
| NPI: | 1750739710 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNITED METHODIST WESTERN KANSAS MEXICAN AMERICAN MINISTRIES, INC. | ||||||||
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| OtherOrganizationName: | GENESIS FAMILY HEALTH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 122 W LAUREL | ||||||||
| Address2: | |||||||||
| City: | GARDEN CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 67846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202717400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 202 W KANSAS AVE | ||||||||
| Address2: | |||||||||
| City: | ULYSSES | ||||||||
| State: | KS | ||||||||
| PostalCode: | 678802034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6203565870 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2016 | ||||||||
| LastUpdateDate: | 06/01/2016 | ||||||||
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| AuthorizedOfficialLastName: | WRIGHT | ||||||||
| AuthorizedOfficialFirstName: | JULIE | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6202717400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.