Organization
EMERGENCY SPECIALTY SERVICES AFFILIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN HENSON MD (OWNER)
(316) 684-3838
Entity
Organization
Contact information
Practice address
3515 BROADWAY AVE, GREAT BEND, KS 67530-3633
(316) 684-3838
Mailing address
6896 W SNOWVILLE RD, BRECKSVILLE, OH 44141-3214
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200576730A
—
KS
Enumeration date
06/20/2008
Last updated
01/16/2009
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