Organization
DERMATOLOGY LASER CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAREK J KAMINSKI MD (OWNER)
(620) 624-9100
Entity
Organization
Contact information
Practice address
15 E 11TH ST, LIBERAL, KS 67901-2720
(620) 624-9100
(620) 624-9107
Mailing address
15 E 11TH ST, LIBERAL, KS 67901-2720
(620) 624-9100
(620) 624-9107
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB2646
RAILROAD MEDICARE
KS
Enumeration date
05/08/2007
Last updated
02/12/2008
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