Organization
CENTRAL KANSAS MEDICAL CENTER
Active
Other names
St. Joseph Family Medicine - Great Bend
Organization subpart
No
Provider details
NPI number
Authorized official
LEANNE IRSIK (SR. VP/SITE ADMINISTRATOR)
(620) 786-6163
Entity
Organization
Contact information
Practice address
3520 LAKIN AVE, SUITE 103, GREAT BEND, KS 67530-3646
(620) 792-3345
(620) 792-3767
Mailing address
3520 LAKIN AVE, SUITE 103, GREAT BEND, KS 67530-3646
(620) 792-3767
(620) 792-3767
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080680H
—
KS
Enumeration date
08/15/2008
Last updated
11/27/2012
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