Organization
UKHS GREAT BEND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE MOCK (CEO)
(620) 791-6272
Entity
Organization
Contact information
Practice address
3515 BROADWAY AVE, GREAT BEND, KS 67530-3633
(620) 867-6184
(620) 793-6014
Mailing address
3515 BROADWAY AVE, GREAT BEND, KS 67530-3633
(620) 867-6184
(620) 793-6014
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/13/2019
Last updated
05/13/2019
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