Individual
MARTA J EDMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1021 EISENHOWER AVE, GREAT BEND CHILDREN'S CLINIC, P.A., GREAT BEND, KS 67530-3213
(620) 792-5437
Mailing address
209 NE 10 RD, PO BOX 1816, GREAT BEND, KS 67530-8818
(620) 792-4121
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0423536
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045811
BLUE CROSS BLUE SHIELD KS
KS
05
—
100127410A
—
KS
Enumeration date
01/06/2006
Last updated
05/25/2021
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