Individual
EDMOND HABASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A-C
Contact information
Practice address
3515 BROADWAY AVE, SUITE 107, GREAT BEND, KS 67530-3633
(620) 793-8429
(620) 793-6014
Mailing address
PO BOX 310, GREAT BEND, KS 67530-0310
(620) 786-6475
(620) 786-6155
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1500579
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100359440B
—
KS
Enumeration date
05/09/2006
Last updated
09/22/2025
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