Renovo Medical LLC

NPI #1083864219 in Garden City, Kansas

Provider Information

NPI Number: 1083864219
Entity Type: Organization
Organization Name: Renovo Medical LLC
Primary Specialty: General Practice
Enumeration Date: Sep 24, 2008
Last Updated: Mar 5, 2016

Practice Location

Address: 816 N CAMPUS DR
Address 2: SUITE 500
City: Garden City
State: Kansas
ZIP Code: 67846-6329
Phone: (620) 805-5162

Authorized Official

Name: PROF. JOEL T ERSKIN, SCD PA-C
Title: CEO/PHYSICIAN ASSISTANT
Phone: (620) 805-5162

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Phlebology	202K00000X
Physician Assistant - Surgical — Surgical	363AS0400X
Nurse Practitioner - Family — Family	363LF0000X
General Practice	208D00000X	Primary

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