Organization
SAM R. FUNK, O.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAM R FUNK OD (OPTOMETRIST)
(785) 462-3348
Entity
Organization
Contact information
Practice address
505 N FRANKLIN AVE STE B, COLBY, KS 67701-2342
(785) 462-3348
(785) 462-3599
Mailing address
505 N FRANKLIN AVE STE B, COLBY, KS 67701-2342
(785) 462-3348
(785) 462-3599
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11113
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001269
BCBS
—
01
—
005149
BC/BS
KS
05
—
100090170A
—
KS
01
—
12589230
CAQH
—
05
—
201083380A
—
KS
01
—
656990
FIRST GUARD
KS
Enumeration date
08/22/2006
Last updated
02/24/2016
Update your record
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