Individual
RHETT DAVID BOUZIDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
625 KENTUCKY ST, ASHLAND, KS 67831-3199
(620) 635-2241
Mailing address
PO BOX 188, ASHLAND, KS 67831-0188
(620) 635-2241
(620) 635-2229
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1501058
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200360070A
—
KS
Enumeration date
07/09/2006
Last updated
01/22/2021
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