Organization
MARK A. JUDD, OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN H AISTRUP (OFFICE MANAGER)
(620) 792-8733
Entity
Organization
Contact information
Practice address
1701 STATE ROAD 96, GREAT BEND, KS 67530-3014
(620) 792-8733
(620) 792-3621
Mailing address
1701 STATE ROAD 96, GREAT BEND, KS 67530-3014
(620) 792-8733
(620) 792-3621
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1484-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100280160D
—
KS
Enumeration date
12/11/2006
Last updated
12/04/2007
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