Benny Lee Short, MD | |
200 W Ross Blvd, Dodge City, KS 67801-7221 | |
(620) 371-7300 | |
(620) 371-7304 |
Full Name | Benny Lee Short |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 200 W Ross Blvd, Dodge City, Kansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104854553 | NPI | - | NPPES |
102645 | Other | KS | BC/BS |
100354710C | Medicaid | KS | |
100354710I | Medicaid | KS | |
100354710H | Medicaid | KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 04-28386 (Kansas) | Secondary |
207P00000X | Emergency Medicine | 04-28386 (Kansas) | Primary |
Entity Name | Emergency Services Of Kansas, P.a. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023397098 PECOS PAC ID: 2062683808 Enrollment ID: O20110927000555 |
Mailing Address | Practice Location Address |
---|---|
Benny Lee Short, MD 200 W Ross Blvd, Dodge City, KS 67801-7221 Ph: (620) 371-7300 | Benny Lee Short, MD 200 W Ross Blvd, Dodge City, KS 67801-7221 Ph: (620) 371-7300 |
Mr. Bailey Stapleman, ATC Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 2201 W Ross Blvd, Dodge City, KS 67801 Phone: 620-371-1023 | |
Dr. James W Moffitt, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 200 W Ross Blvd, Dodge City, KS 67801 Phone: 620-371-7300 Fax: 620-371-7304 |