Individual
KENNETH K GOERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3901 RAINBOW BLVD, 2026 MILLER MAIL STOP 4004, KANSAS CITY, KS 66160
(913) 588-6301
(913) 588-6319
Mailing address
3901 RAINBOW BLVD, 4070 DELP MAIL STOP 4017, KANSAS CITY, KS 66160-7816
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
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