| Southeast Kansas Medical Associates | |
|
1501 W 4th St Coffeyville KS 67337-3307 | |
| (620) 251-2400 | |
| (620) 251-1619 |
| Full Name | Southeast Kansas Medical Associates |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1501 W 4th St, Coffeyville, Kansas |
| Authorized Official Name and Position | Jerome Block (OWNER) |
| Authorized Official Contact | 6202512400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Kansas Medical Associates 1501 W 4th St Coffeyville KS 67337-3307 Ph: (620) 251-2400 | Southeast Kansas Medical Associates 1501 W 4th St Coffeyville KS 67337-3307 Ph: (620) 251-2400 |
| NPI Number | 1184736563 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184736563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0420630 (Kansas) | Primary |
| 363L00000X | Nurse Practitioner | 44318 (Kansas) | Primary |
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