Individual
MARION SUSAN RODGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3520 LAKIN AVE, SUITE 103, GREAT BEND, KS 67530-3660
(620) 792-3345
(620) 792-3767
Mailing address
PO BOX 969, GREAT BEND, KS 67530-0969
(620) 786-6475
(620) 786-6155
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
04-25143
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100161240C
—
KS
01
—
1649411158
BCBSKS
KS
Enumeration date
03/12/2009
Last updated
11/03/2009
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