Organization
GREENBUSH EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(954) 838-2371
Entity
Organization
Contact information
Practice address
317 HIGHWAY 13 S, MORTON, MS 39117-3353
(469) 401-2386
Mailing address
13737 NOEL RD, STE 1600, DALLAS, TX 75240-1331
(954) 838-2371
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00931235
—
MS
Enumeration date
08/30/2011
Last updated
08/27/2019
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