Individual
JERZY SLOMKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1602 N AYLWARD AVE, ELLSWORTH, KS 67439-2541
(785) 472-3111
(785) 472-5731
Mailing address
1602 N AYLWARD AVE, PO BOX 103, ELLSWORTH, KS 67439-2541
(785) 472-3111
(785) 472-5731
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-25637
KS
207R00000X
Internal Medicine Physician
04-25637
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058327
BLUE CROSS BLUE SHIELD
KS
01
—
060676
BCBS
KS
05
—
100177140C
—
KS
05
—
100177140D
—
KS
01
—
622680
FIRST GUARD
KS
01
—
622682
FIRSTGUARD
KS
Enumeration date
07/27/2005
Last updated
12/17/2009
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