Individual
KENNETH K GOERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
04-17109
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09325014
BCBS KANSAS CITY
MO
05
—
100168740A
—
KS
01
—
110129358
RAILROAD MEDICARE
—
05
—
201128808
—
MO
01
—
625860
FIRSTGUARD
KS
Enumeration date
08/30/2006
Last updated
07/09/2007
Update your record
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