Organization
MARTIN R FUNK OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN R FUNK O.D. (PRESIDENT)
(620) 431-2300
Entity
Organization
Contact information
Practice address
1 E 2ND ST, CHANUTE, KS 66720-2460
(620) 431-2300
Mailing address
1 E 2ND ST, PO BOX 497, CHANUTE, KS 66720-2460
(620) 431-2300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1351-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100219180A
—
KS
Enumeration date
11/15/2006
Last updated
02/22/2011
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