| Marta J Edmonds, MD | |
| 1021 Eisenhower Ave, Great Bend Children's Clinic, P.a., Great Bend, KS 67530-3213 | |
| (620) 792-5437 | |
| Not Available | 
| Full Name | Marta J Edmonds | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 1021 Eisenhower Ave, Great Bend, Kansas | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1669450847 | NPI | - | NPPES | 
| 045811 | Other | KS | BLUE CROSS BLUE SHIELD KS | 
| 100127410A | Medicaid | KS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 0423536 (Kansas) | Primary | 
| Entity Name | Ukhs Great Bend Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1962997197 PECOS PAC ID: 5597016378 Enrollment ID: O20180918000770 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Marta J Edmonds, MD 209 Ne 10 Rd, Po Box 1816, Great Bend, KS 67530-8818 Ph: (620) 792-4121 | Marta J Edmonds, MD 1021 Eisenhower Ave, Great Bend Children's Clinic, P.a., Great Bend, KS 67530-3213 Ph: (620) 792-5437 | 
| Dr. Christopher Joseph Koster, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1021 Eisenhower Ave, Great Bend, KS 67530 Phone: 620-792-5437 | |
| Ryan M Williams, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1021 Eisenhower Ave, Great Bend Children's Clinic, Great Bend, KS 67530 Phone: 620-792-5437 Fax: 620-793-5245 |