Organization
GREAT PLAINS DERMATOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD KENNETH TILLMAN JR. D.O. (PRESIDENT)
(785) 625-7546
Entity
Organization
Contact information
Practice address
2708 STERNBERG DR, HAYS, KS 67601-1922
(785) 625-7546
(785) 625-7598
Mailing address
2708 STERNBERG DR, HAYS, KS 67601
(785) 625-7546
(785) 625-7598
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0523958
KS
Other
Enumeration date
09/25/2006
Last updated
02/25/2011
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