1205949203 NPI number — DANIEL J. SANCHEZ, M.D., P.A.

Table of content: (NPI 1205949203)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205949203 NPI number — DANIEL J. SANCHEZ, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANIEL J. SANCHEZ, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205949203
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1210 N. WASHINGTON, CLINIC B
Provider Second Line Business Mailing Address:
P.O. BOX 407
Provider Business Mailing Address City Name:
PLAINVILLE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67663-0407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-434-2622
Provider Business Mailing Address Fax Number:
785-434-2577

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1210 N. WASHINGTON, CLINIC B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINVILLE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-434-2622
Provider Business Practice Location Address Fax Number:
785-434-2577
Provider Enumeration Date:
08/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SANCHEZ
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
785-434-2622

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  04-24739 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100146370B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0399 . This is a "BC/BS RURAL HEALTH GROUP" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 623170 . This is a "FIRSTGUARD PROVIDER #" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 102317 . This is a "BC/BS REG INDIVIDUAL" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 110809 . This is a "BC/BS GROUP" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 100427890B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100427890A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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