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Organization
UKHS GREAT BEND, LLC
Active
Organization
UKHS GREAT BEND, LLC
Active
Other names
UKHS Great Bend St. Rose Pavilion, UKHS St. Rose Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE MOCK (CEO)
(620) 791-6272
Entity
Organization
Contact information
Practice address
3515 BROADWAY AVE, GREAT BEND, KS 67530-3633
(620) 786-6163
(620) 786-6298
Mailing address
3515 BROADWAY AVE, GREAT BEND, KS 67530-3633
(620) 786-6163
(620) 786-6298
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
Other
Enumeration date
10/29/2018
Last updated
03/11/2020
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