Organization
CENTRAL KANSAS FAMILY PRACTICE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PERRY M SMITH M.D. (PRESIDENT)
(620) 792-5341
Entity
Organization
Contact information
Practice address
1309 POLK ST, GREAT BEND, KS 67530-3618
(620) 792-5341
(620) 792-3702
Mailing address
1309 POLK ST, GREAT BEND, KS 67530-3618
(620) 792-5341
(620) 792-3702
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016135
BLUE SHIELD
KS
01
—
173885
RURAL HEALTH MEDICARE
KS
Enumeration date
08/09/2005
Last updated
08/22/2020
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