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Individual

BARTON TODD HERNDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SOCIAL WORKER

Contact information

Practice address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Mailing address
32 ROSE LOOP, FORT LEAVENWORTH, KS 66027-1148
(580) 695-3420

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12735
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1117051184
TRICARE PRIME FOR RETIREES
KS
Enumeration date
08/16/2022
Last updated
08/16/2022
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