# SOUTHEAST KANSAS MEDICAL ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184736563
- **Authorized official:** JEROME BLOCK M.D. (OWNER)
- **Authorized official phone:** (620) 251-2400

## Contact information

- **Practice address:** 1501 W 4TH ST, COFFEYVILLE, KS 67337-3307
- **Practice address phone:** (620) 251-2400
- **Practice address fax:** (620) 251-1619
- **Mailing address:** 1501 W 4TH ST, COFFEYVILLE, KS 67337-3307
- **Mailing address phone:** (620) 251-2400
- **Mailing address fax:** (620) 251-1619

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 0420630 | KS | — |
| 363L00000X | Nurse Practitioner | 44318 | KS | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 09/11/2025