Edmonds, Marta J

Edmonds, Marta J is an individual health care provider with primary practice located at 1021 Eisenhower Ave Great Bend Children'S Clinic, P.A., Great Bend KS 67530-3213. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Edmonds, Marta J can be contacted via phone (620) 792-5437.

Contact Information

Primary practice address
1021 Eisenhower Ave Great Bend Children'S Clinic, P.A. Great Bend KS 67530-3213
Phone: (620) 792-5437
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0423536 Kansas

Profile Details

NPI number 1669450847
LBN Legal business name Edmonds, Marta J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 6th, 2006
Last updated May 25th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669450847 NPPES
Kansas Other 045811 BLUE CROSS BLUE SHIELD KS
Kansas MEDICAID 100127410A BLUE CROSS BLUE SHIELD KS

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