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Organization

JOHN VRTISKA MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN NORMAN VRTISKA MD (MD PRESIDENT)
(620) 225-5496
Entity
Organization

Contact information

Practice address
112 ROSS BLVD, SUITE A, DODGE CITY, KS 67801-7219
(620) 225-5496
(620) 225-5495
Mailing address
112 ROSS BLVD, SUITE A, DODGE CITY, KS 67801-7219
(620) 225-5496
(620) 225-5495

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
T01174
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
KS
Enumeration date
06/01/2007
Last updated
08/22/2020
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