Organization
CENTRAL KANSAS MEDICAL CENTER
Active
Other names
Great Bend Internists
Organization subpart
No
Provider details
NPI number
Authorized official
LEANNE IRSIK (SR. VP/SITE ADMINISTRATOR)
(620) 786-6163
Entity
Organization
Contact information
Practice address
3515 BROADWAY AVE, SUITE 107, GREAT BEND, KS 67530-3633
(620) 786-6184
(620) 793-6014
Mailing address
3515 BROADWAY, GREAT BEND, KS 67530-3657
(620) 793-8429
(620) 793-6014
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080680F
—
KS
Enumeration date
08/15/2008
Last updated
02/08/2013
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